Provider Demographics
NPI:1548258692
Name:WU, HO-SHYUAN (PHD)
Entity type:Individual
Prefix:DR
First Name:HO-SHYUAN
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SEDGEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-3032
Mailing Address - Country:US
Mailing Address - Phone:973-885-9200
Mailing Address - Fax:
Practice Address - Street 1:92 E MAIN ST STE 411
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2319
Practice Address - Country:US
Practice Address - Phone:908-304-5953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00425700103TC0700X
NJ35S100425700103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0069752Medicaid
NJ092004Medicare ID - Type Unspecified