Basic Information
| Provider Information | |||||||||
| NPI: | 1720602055 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WU | ||||||||
| FirstName: | VALERIE | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | PHYSICIAN ASSISTANT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 80 LOCUST RD | ||||||||
| Address2: | |||||||||
| City: | BRIARCLIFF MANOR | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105101223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8175253688 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1825 EASTCHESTER RD | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104612301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189042400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2020 | ||||||||
| LastUpdateDate: | 04/13/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 025028 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.