Provider Demographics
NPI:1124215827
Name:FU, PAULINE P (DPM)
Entity Type:Individual
Prefix:DR
First Name:PAULINE
Middle Name:P
Last Name:FU
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16407 99TH ST
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-4041
Mailing Address - Country:US
Mailing Address - Phone:646-508-1923
Mailing Address - Fax:607-697-2049
Practice Address - Street 1:280 MADISON AVE RM 202
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0816
Practice Address - Country:US
Practice Address - Phone:212-889-2318
Practice Address - Fax:212-889-2318
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006198213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist