Provider Demographics
NPI:1306990726
Name:WU, SHUYUNG J (MD)
Entity type:Individual
Prefix:
First Name:SHUYUNG
Middle Name:J
Last Name:WU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:896 TARGEE ST
Mailing Address - Street 2:FLOOR 1
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-4517
Mailing Address - Country:US
Mailing Address - Phone:718-816-8200
Mailing Address - Fax:718-816-0892
Practice Address - Street 1:896 TARGEE ST
Practice Address - Street 2:FLOOR 1
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-4517
Practice Address - Country:US
Practice Address - Phone:718-816-8200
Practice Address - Fax:718-816-0892
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA229492207R00000X
NY253362207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine