Provider Demographics
NPI:1861456196
Name:WU, REX H (MD)
Entity Type:Individual
Prefix:
First Name:REX
Middle Name:H
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 1:128 MOTT ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-5540
Mailing Address - Country:US
Mailing Address - Phone:212-343-9716
Mailing Address - Fax:212-343-9717
Practice Address - Street 1:128 MOTT STREET
Practice Address - Street 2:SUITE 402
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-5575
Practice Address - Country:US
Practice Address - Phone:212-343-9716
Practice Address - Fax:212-343-9717
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209929207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H02686Medicare UPIN