Provider Demographics
NPI:1437718210
Name:WU, JASON (OD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:WU
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 WATKINS ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-1653
Mailing Address - Country:US
Mailing Address - Phone:610-757-8682
Mailing Address - Fax:
Practice Address - Street 1:2106 MOUNT HOLLY RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-4158
Practice Address - Country:US
Practice Address - Phone:609-386-5916
Practice Address - Fax:609-386-8023
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003564152W00000X
NJ27OA00704400152W00000X
AK192622152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist