Provider Demographics
NPI:1710306956
Name:SEAN X. LUO, M.D., PH.D., LLC
Entity Type:Organization
Organization Name:SEAN X. LUO, M.D., PH.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:XIAO
Authorized Official - Last Name:LUO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:516-418-6259
Mailing Address - Street 1:252 W 85TH ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3244
Mailing Address - Country:US
Mailing Address - Phone:516-418-6259
Mailing Address - Fax:646-786-3772
Practice Address - Street 1:252 W 85TH ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3244
Practice Address - Country:US
Practice Address - Phone:516-418-6259
Practice Address - Fax:646-786-3772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60261934261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty