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General NPI Number Information
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NPI Number | 1851654321
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Entity Type | Individual
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Provider Name | RICHARD WU O.D.
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Gender | Male
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Dates
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Enumeration Date | 06/20/2012
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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 | 917-886-1556
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV007861
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License Number State | NY
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