Individual
DA WU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(617) 669-8422
Mailing address
324 AVALON GARDENS DR, NANUET, NY 10954-7414
(617) 669-8422
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
337541
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2019
Last updated
05/08/2026
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