Provider Demographics
NPI:1871918086
Name:WU, ZHENTAO (L AC)
Entity type:Individual
Prefix:
First Name:ZHENTAO
Middle Name:
Last Name:WU
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900B EAST TREMONT AVENUE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 E TREMONT AVE
Practice Address - Street 2:# B
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-4355
Practice Address - Country:US
Practice Address - Phone:347-918-8822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-25
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002893171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist