Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 265291 | NY |
N | 204F00000X | Transplant Surgeon | E-4123 | AR |
N | 208200000X | Surgeon | E-4123 | AR |
N | 208600000X | Surgeon | E-4123 | AR |
NPI | 1316037989 |
---|---|
Provider Name | Youmin Wu |
First Address | Valhalla, NY 10595-1530 |
Second Address | Valhalla, NY 10595-1530 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 20/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04070016800 | QUALCHOICE (01) | AR |
154206001 | (05) | AR |
5M889 | BLUE CROSS BLUE SHIELD (01) | AR |
E4123 | TRICARE (01) | AR |
F64591 | (02) | |
P00260044 | RAILROAD MEDICARE (01) |