Provider Demographics
NPI:1881802981
Name:WU, PAUL (LPN)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:WU
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1491 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-2601
Mailing Address - Country:US
Mailing Address - Phone:718-974-2129
Mailing Address - Fax:
Practice Address - Street 1:2533 OCEAN AVE APT C2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3982
Practice Address - Country:US
Practice Address - Phone:929-308-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY271670-01164W00000X
NY2716701164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse