Provider Demographics
NPI:1720272974
Name:WU, AMY CARLUCCI (MD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:CARLUCCI
Last Name:WU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:A
Other - Last Name:CARLUCCI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:282 WASHINGTON ST.
Mailing Address - Street 2:2B
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106
Mailing Address - Country:US
Mailing Address - Phone:860-545-9400
Mailing Address - Fax:860-368-5870
Practice Address - Street 1:282 WASHINGTON ST.
Practice Address - Street 2:2B
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106
Practice Address - Country:US
Practice Address - Phone:860-545-9400
Practice Address - Fax:860-368-5870
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA201656208000000X
CT0484352080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics