Basic Information
Provider Information
NPI: 1083636419
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DU
FirstName: HUI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PA
OtherOrganizationName:  
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OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: NEW YORK HOSPITAL QUEENS WA 100
Address2: 56-45 MAIN ST
City: FLUSHING
State: NY
PostalCode: 11355
CountryCode: US
TelephoneNumber: 7186702627
FaxNumber: 7186702762
Practice Location
Address1: NEW YORK HOSPITAL QUEENS WA 100
Address2: 56-45 MAIN ST
City: FLUSHING
State: NY
PostalCode: 11355
CountryCode: US
TelephoneNumber: 7186702627
FaxNumber: 7186702762
Other Information
ProviderEnumerationDate: 07/24/2006
LastUpdateDate: 11/18/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X005619NYY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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