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NPI 1750582805

NPI 1750582805 : ULYSSES WU : HARTFORD, CT

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General NPI Number Information
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    NPI Number           |    1750582805
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    Entity Type          |    Individual 
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    Provider Name        |    ULYSSES WU
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/29/2007
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    Last Update Date     |    08/06/2018
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Provider Practice Location Address
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    Address Line         |    1000 ASYLUM AVE SUITE 2112
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    City                 |    HARTFORD
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    State                |    CT
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    Zip                  |    06105
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    Country              |    US
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    Telephone            |    860-714-4903
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1000 ASYLUM AVE SUITE 2112
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    City                 |    HARTFORD
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    State                |    CT
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    Zip                  |    06105-1770
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    Country              |    US
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    Telephone            |    860-714-5895
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    Fax                  |    860-714-5417
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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        |    207RI0200X
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    Taxonomy Name        |    Infectious Disease Physician
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    License Number       |    201555
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    License Number State |    LA
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Taxonomy #2
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    Taxonomy Code        |    207RI0200X
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    Taxonomy Name        |    Infectious Disease Physician
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    License Number       |    048510
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    License Number State |    CT
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