Provider Demographics
NPI:1881859957
Name:WU, IRENE YOON (MD)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:YOON
Last Name:WU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 SHORE DR
Mailing Address - Street 2:APT E31
Mailing Address - City:HIGHLANDS
Mailing Address - State:NJ
Mailing Address - Zip Code:07732-1145
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1301 MAIN ST
Practice Address - Street 2:
Practice Address - City:ASBURY PARK
Practice Address - State:NJ
Practice Address - Zip Code:07712-5359
Practice Address - Country:US
Practice Address - Phone:732-774-6333
Practice Address - Fax:732-774-0313
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08326000207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine