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General NPI Number Information
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NPI Number | 1740329960
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Entity Type | Individual
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Provider Name | DIANA WU RPAC
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Gender | Female
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 525 E 68TH ST BOX 294
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City | NEW YORK
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State | NY
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Zip | 10021-4870
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Country | US
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Telephone | 212-746-5294
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Fax | 212-746-5236
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Provider Business Mailing Address
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Address Line | 210 E 15TH ST APT. 7L
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City | NEW YORK
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State | NY
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Zip | 10003-3922
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Country | US
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Telephone | 917-453-0101
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Fax | 212-746-5236
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 004350
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License Number State | NY
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