Provider Demographics
NPI:1407186372
Name:SU, SHU-HUEI
Entity Type:Individual
Prefix:
First Name:SHU-HUEI
Middle Name:
Last Name:SU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6615 WETHEROLE ST
Mailing Address - Street 2:APT D4
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4651
Mailing Address - Country:US
Mailing Address - Phone:718-316-0570
Mailing Address - Fax:
Practice Address - Street 1:3907 PRINCE ST
Practice Address - Street 2:SUITE 4A
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5399
Practice Address - Country:US
Practice Address - Phone:718-661-9909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-28
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0308391225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist