Provider Demographics
NPI:1245562958
Name:WU, JANICE (PHARMD)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13302 41ST AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5874
Mailing Address - Country:US
Mailing Address - Phone:718-353-8600
Mailing Address - Fax:718-353-8655
Practice Address - Street 1:13302 41ST AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5874
Practice Address - Country:US
Practice Address - Phone:718-353-8600
Practice Address - Fax:718-353-8655
Is Sole Proprietor?:No
Enumeration Date:2010-02-04
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053895183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist