Provider Demographics
NPI:1720437387
Name:HU, WEN FAN (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:WEN
Middle Name:FAN
Last Name:HU
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:WEN
Other - Middle Name:
Other - Last Name:FAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE BOX 888
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-273-3937
Mailing Address - Fax:
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-6110
Practice Address - Country:US
Practice Address - Phone:585-273-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-05
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309404207ZN0500X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207ZN0500XAllopathic & Osteopathic PhysiciansPathologyNeuropathology