Provider Demographics
NPI:1225013345
Name:NI, LOU-FU (MD)
Entity Type:Individual
Prefix:DR
First Name:LOU-FU
Middle Name:
Last Name:NI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:56-45 MAIN STREET
Mailing Address - Street 2:W-LL300
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5045
Mailing Address - Country:US
Mailing Address - Phone:718-359-8787
Mailing Address - Fax:718-359-4546
Practice Address - Street 1:133-47 SANFORD AVENUE
Practice Address - Street 2:STE 2
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5045
Practice Address - Country:US
Practice Address - Phone:718-359-8787
Practice Address - Fax:718-359-4546
Is Sole Proprietor?:No
Enumeration Date:2005-12-12
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY132371208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00708856Medicaid
NYB01303Medicare UPIN
NY00708856Medicaid
NY00708856Medicaid