Provider Demographics
NPI:1295834265
Name:WU, ROLAND S (MD)
Entity Type:Individual
Prefix:DR
First Name:ROLAND
Middle Name:S
Last Name:WU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 E 73RD ST APT 4D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3868
Mailing Address - Country:US
Mailing Address - Phone:212-517-2221
Mailing Address - Fax:
Practice Address - Street 1:2525 KINGS HWY
Practice Address - Street 2:NEW YORK COMMUNITY HOSPITAL,DEPT. OF EMERGENCY MEDICINE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1705
Practice Address - Country:US
Practice Address - Phone:718-692-5387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241312207R00000X
CAA110283207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine