Provider Demographics
NPI:1942432836
Name:LUU, ALESHIA NGOC (OD)
Entity Type:Individual
Prefix:
First Name:ALESHIA
Middle Name:NGOC
Last Name:LUU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 JPM RD
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-9313
Mailing Address - Country:US
Mailing Address - Phone:570-523-3937
Mailing Address - Fax:570-524-5279
Practice Address - Street 1:137 JPM RD
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-9313
Practice Address - Country:US
Practice Address - Phone:570-523-3937
Practice Address - Fax:570-524-5279
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002242152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102530152Medicaid
PA102530152Medicaid