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NPI 1962943811

NPI 1962943811 : SIU MAN WOO : CLIFTON, NJ

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General NPI Number Information
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    NPI Number           |    1962943811
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    Entity Type          |    Individual 
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    Provider Name        |    SIU MAN WOO
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/11/2017
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    Last Update Date     |    03/12/2017
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Provider Practice Location Address
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    Address Line         |    605 GROVE ST APT E16 
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    City                 |    CLIFTON
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    State                |    NJ
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    Zip                  |    07013-3868
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    Country              |    US
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    Telephone            |    646-683-0430
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    605 GROVE ST APT E16 
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    City                 |    CLIFTON
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    State                |    NJ
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    Zip                  |    07013-3868
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    Country              |    US
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    Telephone            |    646-683-0430
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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        |    174400000X
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    Taxonomy Name        |    Specialist
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    License Number       |    1397892
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    License Number State |    NY
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