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General NPI Number Information
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NPI Number | 1801713623
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Entity Type | Individual
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Provider Name | BERT WU
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Gender | Male
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Dates
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Enumeration Date | 07/02/2026
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Last Update Date | 07/02/2026
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Provider Practice Location Address
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Address Line | PSC 80 BOX 22177
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City | APO
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State | AP
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Zip | 96367-0106
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Country | US
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Telephone | 544-630-3044
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Fax |
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Provider Business Mailing Address
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Address Line | 104 PINE DR
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City | BLACK RIVER
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State | NY
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Zip | 13612-2110
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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 |
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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 | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | 4745-4811-3813
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License Number State | NY
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