Provider Demographics
NPI:1134620735
Name:SOHO OTOLARYNGOLOGY PC
Entity type:Organization
Organization Name:SOHO OTOLARYNGOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OTOLARYNGOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-233-2268
Mailing Address - Street 1:198 CANAL ST STE 403
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4533
Mailing Address - Country:US
Mailing Address - Phone:212-233-2266
Mailing Address - Fax:888-368-1539
Practice Address - Street 1:198 CANAL ST STE 403
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4533
Practice Address - Country:US
Practice Address - Phone:212-233-2266
Practice Address - Fax:888-368-1539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY270543207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty