Basic Information
Provider Information
NPI: 1295113629
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HU
FirstName: AMY
MiddleName: YAWEN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HU
OtherFirstName: YAWEN
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: DEPARTMENT OF PSYCHIATRY
Address2: 1501 N CAMPBELL AVE
City: TUCSON
State: AZ
PostalCode: 857240001
CountryCode: US
TelephoneNumber: 5206266254
FaxNumber:  
Practice Location
Address1: 1501 N CAMPBELL AVE
Address2: DEPT OF PSYCHIATRY
City: TUCSON
State: AZ
PostalCode: 857245002
CountryCode: US
TelephoneNumber: 5206266795
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/18/2015
LastUpdateDate: 06/29/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XR75023AZY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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