Provider Demographics
NPI:1477532828
Name:MARJI, LUAY S (MD)
Entity Type:Individual
Prefix:
First Name:LUAY
Middle Name:S
Last Name:MARJI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LUAY
Other - Middle Name:S
Other - Last Name:MARJI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:9 HIDDEN GLEN RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1230
Mailing Address - Country:US
Mailing Address - Phone:914-375-4433
Mailing Address - Fax:914-375-1771
Practice Address - Street 1:147 PARK AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-2937
Practice Address - Country:US
Practice Address - Phone:914-375-4433
Practice Address - Fax:914-375-1771
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204489207Q00000X, 207QA0000X, 207QA0505X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY665852Medicare PIN