Provider Demographics
NPI:1063765923
Name:WOUND PHYSICIAN PLLC
Entity type:Organization
Organization Name:WOUND PHYSICIAN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MU-I
Authorized Official - Middle Name:KAREN
Authorized Official - Last Name:KUO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-542-3368
Mailing Address - Street 1:4142 COLLEGE POINT BLVD STE 2A
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-4386
Mailing Address - Country:US
Mailing Address - Phone:347-542-3368
Mailing Address - Fax:718-939-6235
Practice Address - Street 1:4142 COLLEGE POINT BLVD STE 2A
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-4386
Practice Address - Country:US
Practice Address - Phone:347-542-3368
Practice Address - Fax:718-939-6235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-16
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty