Provider Demographics
NPI:1518079284
Name:WU, JOANNE (MD)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2655 RIDGEWAY AVE
Mailing Address - Street 2:SUITE 440
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4296
Mailing Address - Country:US
Mailing Address - Phone:585-368-3213
Mailing Address - Fax:585-368-3219
Practice Address - Street 1:2655 RIDGEWAY AVE
Practice Address - Street 2:SUITE 440
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4296
Practice Address - Country:US
Practice Address - Phone:585-368-3213
Practice Address - Fax:585-368-3219
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY246818208100000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00884038OtherMEDICARE RAILROAD
NY03216786Medicaid
NYP00884038OtherMEDICARE RAILROAD
NYJ400020512/BA0017GRPMedicare PIN