Provider Demographics
NPI:1427164698
Name:HU, YOUJUN (MD)
Entity type:Individual
Prefix:
First Name:YOUJUN
Middle Name:
Last Name:HU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1559
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790
Mailing Address - Country:US
Mailing Address - Phone:631-444-9024
Mailing Address - Fax:631-444-3424
Practice Address - Street 1:100 NICOLLS ROAD
Practice Address - Street 2:UNIVERSITY HOSPITAL AT STONY BROOK
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794
Practice Address - Country:US
Practice Address - Phone:631-444-9024
Practice Address - Fax:631-444-3424
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY218550207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02089150Medicaid
NY01Q421OtherEMPIRE BCBS
H20563Medicare UPIN
NY02089150Medicaid