Provider Demographics
NPI:1265015994
Name:LUO, MIN HONG
Entity Type:Individual
Prefix:
First Name:MIN HONG
Middle Name:
Last Name:LUO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 WADSWORTH AVE APT 33
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-3167
Mailing Address - Country:US
Mailing Address - Phone:917-306-9171
Mailing Address - Fax:
Practice Address - Street 1:515 AUDUBON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-3403
Practice Address - Country:US
Practice Address - Phone:917-306-9171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY681367163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice