Provider Demographics
NPI:1932103272
Name:LUY, JEFFREY S (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:S
Last Name:LUY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 TELESTAR CT STE 300
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1263
Mailing Address - Country:US
Mailing Address - Phone:703-591-1688
Mailing Address - Fax:703-591-1445
Practice Address - Street 1:11800 SUNRISE VALLEY DR STE 500
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-5303
Practice Address - Country:US
Practice Address - Phone:703-437-5977
Practice Address - Fax:703-478-2475
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101234176207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1932103272Medicaid
DCP00007584OtherRAILROAD MEDICARE DC #
DC034543500Medicaid
MD401040000Medicaid
VAP00007586OtherRAILROAD MEDICARE VA #
VAG98546Medicare UPIN
VAP00007586OtherRAILROAD MEDICARE VA #
VA1932103272Medicaid
DC011356C42Medicare PIN