Provider Demographics
NPI:1598745069
Name:WU, HSILONG (DMD)
Entity Type:Individual
Prefix:DR
First Name:HSILONG
Middle Name:
Last Name:WU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 CITY PL
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-3155
Mailing Address - Country:US
Mailing Address - Phone:201-266-0623
Mailing Address - Fax:608-541-5400
Practice Address - Street 1:185 PARK ROW
Practice Address - Street 2:SUITE 9
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-5000
Practice Address - Country:US
Practice Address - Phone:212-732-1329
Practice Address - Fax:212-732-6005
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0525691223G0001X
NJ22DI023065001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02712307Medicaid