Provider Demographics
NPI:1649461104
Name:WU, YAN
Entity type:Individual
Prefix:PROF
First Name:YAN
Middle Name:
Last Name:WU
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 1:267 5TH AVE
Mailing Address - Street 2:SUITE 806
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-7503
Mailing Address - Country:US
Mailing Address - Phone:212-685-7067
Mailing Address - Fax:212-781-3008
Practice Address - Street 1:267 5TH AVE
Practice Address - Street 2:SUITE 806
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-7503
Practice Address - Country:US
Practice Address - Phone:212-685-7067
Practice Address - Fax:212-781-3008
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000566171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist