Active NPI
Peter Jun Pen Wu, LIC. AC
- Acupuncturist
- Great Neck, NY
National Provider Identifier
1245672690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 5125
- Practice address
- 20 Ravine Rd
Great Neck, NY 11023-1712 - Phone
- (212) 643-2424
- NPI assigned
- Jul 26, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 5125 | NY | Primary |
Addresses
Primary practice location
20 Ravine Rd
Great Neck, NY 11023-1712
Mailing address
20 Ravine Rd
Great Neck, NY 11023-1712
Phone (212) 643-2424
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5125 | NY | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RVC Acu LLC | Acupuncturist | Current | Accepting new patients |
| BL Mass LLC | Current | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- East Meadow, NY
- NPI 1518642131
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374796800000",
"number": "1245672690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 RAVINE RD",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110231712",
"telephone_number": "212-643-2424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 RAVINE RD",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110231712",
"telephone_number": "212-643-2424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WU",
"first_name": "PETER",
"middle_name": "JUN PEN",
"credential": "LIC. AC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-07-26",
"last_updated": "2013-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "5125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.