Provider Demographics
NPI:1336616424
Name:SHEN, WEI YU
Entity Type:Individual
Prefix:
First Name:WEI YU
Middle Name:
Last Name:SHEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11518-1208
Mailing Address - Country:US
Mailing Address - Phone:516-399-2225
Mailing Address - Fax:516-399-2227
Practice Address - Street 1:510 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:EAST ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11518-1208
Practice Address - Country:US
Practice Address - Phone:516-399-2225
Practice Address - Fax:516-399-2227
Is Sole Proprietor?:No
Enumeration Date:2018-10-27
Last Update Date:2018-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004051171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist