Provider Demographics
NPI:1487012506
Name:WU, WAIMING (RPH)
Entity Type:Individual
Prefix:
First Name:WAIMING
Middle Name:
Last Name:WU
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14601 45TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-2200
Mailing Address - Country:US
Mailing Address - Phone:718-353-3160
Mailing Address - Fax:718-353-0647
Practice Address - Street 1:14601 45TH AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2200
Practice Address - Country:US
Practice Address - Phone:718-353-3160
Practice Address - Fax:718-353-0647
Is Sole Proprietor?:No
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047947183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist