Provider Demographics
NPI:1053464271
Name:LUE, SHARON P (OD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:P
Last Name:LUE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1498 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1498 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1410
Practice Address - Country:US
Practice Address - Phone:212-249-6294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2013-07-25
Deactivation Date:2010-03-17
Deactivation Code:
Reactivation Date:2013-07-25
Provider Licenses
StateLicense IDTaxonomies
NYTUV004370-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist