Provider Demographics
NPI:1932144995
Name:YU, LIO (MD)
Entity Type:Individual
Prefix:
First Name:LIO
Middle Name:
Last Name:YU
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 1:4022 MAIN ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5651
Mailing Address - Country:US
Mailing Address - Phone:347-532-2888
Mailing Address - Fax:718-321-8620
Practice Address - Street 1:4022 MAIN ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5651
Practice Address - Country:US
Practice Address - Phone:347-532-2888
Practice Address - Fax:718-321-8620
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1848192085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01531731Medicaid
NY26J651Medicare PIN