Provider Demographics
NPI:1669813804
Name:JOO, LUCY MIN (DO)
Entity Type:Individual
Prefix:DR
First Name:LUCY
Middle Name:MIN
Last Name:JOO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 FRIES MILL RD STE N1
Mailing Address - Street 2:
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2055
Mailing Address - Country:US
Mailing Address - Phone:856-783-2241
Mailing Address - Fax:
Practice Address - Street 1:188 FRIES MILL RD STE N1
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-2055
Practice Address - Country:US
Practice Address - Phone:856-783-2241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09763200207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology