Provider Demographics
NPI:1588633135
Name:SUN, WEI Y (MD)
Entity Type:Individual
Prefix:DR
First Name:WEI
Middle Name:Y
Last Name:SUN
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 1:139 CENTRE STREET
Mailing Address - Street 2:SUITE 703
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013
Mailing Address - Country:US
Mailing Address - Phone:212-966-0808
Mailing Address - Fax:212-966-0880
Practice Address - Street 1:139 CENTRE STREET
Practice Address - Street 2:SUITE 703
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013
Practice Address - Country:US
Practice Address - Phone:212-966-0808
Practice Address - Fax:212-966-0880
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225877174400000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI14242Medicare UPIN
NY242AP1Medicare ID - Type Unspecified
NY02587424Medicaid