Provider Demographics
NPI:1861935843
Name:WU MACHUCA, ANA
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:WU MACHUCA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E 56TH ST
Mailing Address - Street 2:10TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3607
Mailing Address - Country:US
Mailing Address - Phone:212-759-2211
Mailing Address - Fax:212-379-2130
Practice Address - Street 1:120 E 56TH ST
Practice Address - Street 2:SUITE 835
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3607
Practice Address - Country:US
Practice Address - Phone:646-790-7465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-23
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0410862251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic