Provider Demographics
NPI:1053404707
Name:LUO, CHIH-YUN (NP)
Entity type:Individual
Prefix:MS
First Name:CHIH-YUN
Middle Name:
Last Name:LUO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79-01 BROADWAY
Mailing Address - Street 2:D1-01
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1329
Mailing Address - Country:US
Mailing Address - Phone:718-334-2508
Mailing Address - Fax:718-334-5990
Practice Address - Street 1:79-01 BROADWAY
Practice Address - Street 2:D4 -54 CARDIOLOGY DEPT
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1329
Practice Address - Country:US
Practice Address - Phone:718-334-2508
Practice Address - Fax:718-334-5990
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF302343363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00330128Medicare ID - Type Unspecified
NY00246075Medicaid