Provider Demographics
NPI:1477631315
Name:LUI, KIN W (MD)
Entity Type:Individual
Prefix:DR
First Name:KIN
Middle Name:W
Last Name:LUI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:139 CENTRE ST
Mailing Address - Street 2:ROOM 738
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4552
Mailing Address - Country:US
Mailing Address - Phone:212-274-0151
Mailing Address - Fax:212-274-0211
Practice Address - Street 1:139 CENTRE ST.
Practice Address - Street 2:ROOM 738
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4116
Practice Address - Country:US
Practice Address - Phone:212-274-0151
Practice Address - Fax:212-274-0211
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY170686-1208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01696304Medicaid
NYKL020I4010Medicare ID - Type Unspecified
NYF21032Medicare UPIN