Provider Demographics
NPI:1871370999
Name:WU, JIE
Entity type:Individual
Prefix:
First Name:JIE
Middle Name:
Last Name:WU
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 1:3190 140TH ST APT 5F
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-2140
Mailing Address - Country:US
Mailing Address - Phone:917-244-1959
Mailing Address - Fax:
Practice Address - Street 1:3190 140TH ST APT 5F
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-2140
Practice Address - Country:US
Practice Address - Phone:917-244-1959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY608823163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse