Provider Demographics
NPI:1942945845
Name:JI, LUYAO
Entity Type:Individual
Prefix:
First Name:LUYAO
Middle Name:
Last Name:JI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 1ST AVE APT 16R
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2340
Mailing Address - Country:US
Mailing Address - Phone:669-295-8985
Mailing Address - Fax:
Practice Address - Street 1:685 1ST AVE APT 16R
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2340
Practice Address - Country:US
Practice Address - Phone:669-295-8985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health