Basic Information
Provider Information
NPI: 1215109004
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YU
FirstName: PETER
MiddleName: TZE-WEI
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 EAST PENN SQUARE
Address2: THE WANAMAKER BLDG. 9TH FLOOR
City: PHILADELPHIA
State: PA
PostalCode: 191044306
CountryCode: US
TelephoneNumber: 2674259538
FaxNumber: 2674259552
Practice Location
Address1: 34TH & CIVIC CENTER BLVD
Address2: THE CHILDREN'S HOSPITAL OF PHILADELPHIA
City: PHILADELPHIA
State: PA
PostalCode: 191044306
CountryCode: US
TelephoneNumber: 2155902730
FaxNumber: 2155904875
Other Information
ProviderEnumerationDate: 04/01/2008
LastUpdateDate: 07/28/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XMD450346PAY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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