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General NPI Number Information
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NPI Number | 1659990562
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Entity Type | Organization
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Legal Business Name | RICHARD WU, OPTOMETRIST, PC
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Dates
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Enumeration Date | 04/10/2020
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Last Update Date | 04/24/2020
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Provider Practice Location Address
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Address Line | 6710 FRESH POND RD
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City | RIDGEWOOD
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State | NY
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Zip | 11385-4545
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Country | US
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Telephone | 646-481-8579
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Fax | 646-862-9528
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Provider Business Mailing Address
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Address Line | 17221 83RD AVE
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City | JAMAICA
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State | NY
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Zip | 11432-2103
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OPTOMETRIST
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Name | DR. RICHARD WU
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Credential | OD
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Telephone | 646-481-8579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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