Provider Demographics
NPI:1710915863
Name:LUU, TUYET-LYNN N (PA-C)
Entity Type:Individual
Prefix:MS
First Name:TUYET-LYNN
Middle Name:N
Last Name:LUU
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:TUYET-LYNN
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:800 SPRUCE STREET
Mailing Address - Street 2:1 PINE WEST
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107
Mailing Address - Country:US
Mailing Address - Phone:215-829-7407
Mailing Address - Fax:610-567-6170
Practice Address - Street 1:800 SPRUCE STREET
Practice Address - Street 2:1 PINE WEST
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107
Practice Address - Country:US
Practice Address - Phone:215-829-7407
Practice Address - Fax:610-567-6170
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0000529363A00000X
NJ25MP00361200363AM0700X
PAMA052403363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant