Provider Demographics
NPI:1386867661
Name:LO, GWO YU (LAC)
Entity Type:Individual
Prefix:MR
First Name:GWO
Middle Name:YU
Last Name:LO
Suffix:
Gender:M
Credentials:LAC
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Mailing Address - Street 1:13351 41ST ROAD
Mailing Address - Street 2:#1R
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355
Mailing Address - Country:US
Mailing Address - Phone:718-321-2137
Mailing Address - Fax:718-321-2137
Practice Address - Street 1:13351 41ST ROAD
Practice Address - Street 2:#1R
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-321-2137
Practice Address - Fax:718-321-2137
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY000855171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist