MEDICARE: DAVID WU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PCT.0013151	CT

General Provider Information

NPI Number	:	1851055230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID WU

Provider Business Mailing Address
First Line	:	21 BROOKSIDE DR
Second Line	:
City	:	MIDDLEBURY
State	:	CT
Zip	:	06762-3356
Country	:	US
Telephone Number	:	203-527-7782
Fax Number	:

Provider Business Practice Location Address
First Line	:	405 HARTFORD RD
Second Line	:
City	:	NEW BRITAIN
State	:	CT
Zip	:	06053-1507
Country	:	US
Telephone Number	:	860-893-7011
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2021
Last Update Date	:	10/22/2021

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Directions to “ DAVID WU ” Practice Location

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