Provider Demographics
NPI:1033355052
Name:WU, AMY P (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:P
Last Name:WU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 CANAL ST STE 403
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4533
Mailing Address - Country:US
Mailing Address - Phone:212-233-2266
Mailing Address - Fax:888-368-1539
Practice Address - Street 1:198 CANAL ST STE 403
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4533
Practice Address - Country:US
Practice Address - Phone:212-233-2266
Practice Address - Fax:888-368-1539
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY270543207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03950025Medicaid
NY03950025Medicaid