Provider Demographics
NPI:1750983557
Name:WU, CHRISTINA (RPH)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1561 E BUTLER PIKE
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-2749
Mailing Address - Country:US
Mailing Address - Phone:917-215-1329
Mailing Address - Fax:
Practice Address - Street 1:2622 JENKINTOWN RD
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-2524
Practice Address - Country:US
Practice Address - Phone:917-215-1329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP038555L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist