Individual
MRS. GRACIE MIN-MEI LIN FU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6636 MAIN ST, SUITE 1, WILLIAMSVILLE, NY 14221-5967
(716) 633-0542
(716) 633-0543
Mailing address
6636 MAIN ST, SUITE 1, WILLIAMSVILLE, NY 14221-5967
(716) 633-0542
(716) 633-0543
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
184536
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010105201
UNIVERA
NY
01
—
000511291001
COMMUNITY BLUE
NY
01
—
0104154
INDEPENDENT HEALTH
NY
05
—
01343508
—
NY
Enumeration date
05/19/2006
Last updated
09/28/2007
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