Provider Demographics
NPI:1831715879
Name:WU, FRANK JAY (LAC)
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:JAY
Last Name:WU
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 620789
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362
Mailing Address - Country:US
Mailing Address - Phone:516-469-7478
Mailing Address - Fax:718-691-7010
Practice Address - Street 1:5621 MARATHON PKWY STE 2
Practice Address - Street 2:
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-2037
Practice Address - Country:US
Practice Address - Phone:516-441-2633
Practice Address - Fax:718-691-7010
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-24
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006774171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty