Provider Demographics
NPI:1184003493
Name:LO, CHIU SANG (LPN)
Entity Type:Individual
Prefix:MR
First Name:CHIU
Middle Name:SANG
Last Name:LO
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 EDWARD PL
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-2525
Mailing Address - Country:US
Mailing Address - Phone:845-238-5238
Mailing Address - Fax:
Practice Address - Street 1:104 EDWARD PL
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-2525
Practice Address - Country:US
Practice Address - Phone:845-238-5238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY316741-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse