Provider Demographics
NPI:1629428958
Name:LUU, NINA (PHARMD)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:LUU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 E ELM ST
Mailing Address - Street 2:STE 110
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-1973
Mailing Address - Country:US
Mailing Address - Phone:484-493-1010
Mailing Address - Fax:484-493-1009
Practice Address - Street 1:375 E ELM ST
Practice Address - Street 2:STE 110
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-1973
Practice Address - Country:US
Practice Address - Phone:484-493-1010
Practice Address - Fax:484-493-1009
Is Sole Proprietor?:No
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP447070183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist