Provider Demographics
NPI:1386081222
Name:WU, GUO CHU
Entity type:Individual
Prefix:
First Name:GUO CHU
Middle Name:
Last Name:WU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JEFF
Other - Middle Name:
Other - Last Name:WU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2945 W 23RD ST
Mailing Address - Street 2:APT. 4L
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-2257
Mailing Address - Country:US
Mailing Address - Phone:718-312-2811
Mailing Address - Fax:
Practice Address - Street 1:2945 W 23RD ST
Practice Address - Street 2:APT. 4L
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-2257
Practice Address - Country:US
Practice Address - Phone:718-312-2811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-02
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028693225700000X
NY005064171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty