Basic Information
Provider Information
NPI: 1760649305
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AU
FirstName: ERIC
MiddleName: SHEN-WING
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 525 E 68TH ST
Address2: STARR 4 - CARDIOLOGY
City: NEW YORK
State: NY
PostalCode: 10021
CountryCode: US
TelephoneNumber: 2127462150
FaxNumber:  
Practice Location
Address1: 525 E 68TH ST
Address2: STARR 4 - CARDIOLOGY
City: NEW YORK
State: NY
PostalCode: 10021
CountryCode: US
TelephoneNumber: 2127462150
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/21/2008
LastUpdateDate: 02/11/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X239731-1NYN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0000X239731-1NYY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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