Individual
MS. RAISSA DANIELLE WU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
462 1ST AVE, NEW YORK, NY 10016-9196
(121) 562-5534
Mailing address
462 1ST AVE, NEW YORK, NY 10016-9196
(212) 562-5579
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F381181
NY
363LP2300X
Primary Care Nurse Practitioner
F381181
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
F381181
—
NY
Enumeration date
08/05/2010
Last updated
08/14/2015
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