Provider Demographics
NPI:1578539870
Name:WU, HSI-YANG (MD)
Entity Type:Individual
Prefix:DR
First Name:HSI-YANG
Middle Name:
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 1:195 COLLYER ST STE 201
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-1869
Mailing Address - Country:US
Mailing Address - Phone:401-421-0710
Mailing Address - Fax:401-421-0796
Practice Address - Street 1:2 DUDLEY ST STE 175
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-3246
Practice Address - Country:US
Practice Address - Phone:401-421-0710
Practice Address - Fax:401-421-0796
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD068048L174400000X
CAG79697208800000X, 2088P0231X
RIMD168722088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
No174400000XOther Service ProvidersSpecialist
No208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001886602Medicaid
PA055855FKYMedicare ID - Type Unspecified
PA001886602Medicaid