Provider Demographics
NPI:1205180700
Name:LU, HANNAH MAREAN (PA-C)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:MAREAN
Last Name:LU
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:2337 SOUTH CLINTON AVE
Mailing Address - Street 2:UNIVERSITY OF ROCHESTER SLEEP CENTER
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618
Mailing Address - Country:US
Mailing Address - Phone:585-341-7575
Mailing Address - Fax:585-341-7595
Practice Address - Street 1:2337 SOUTH CLINTON AVE
Practice Address - Street 2:UNIVERSITY OF ROCHESTER SLEEP CENTER
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2645
Practice Address - Country:US
Practice Address - Phone:585-341-7575
Practice Address - Fax:585-341-7595
Is Sole Proprietor?:No
Enumeration Date:2012-11-05
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY015651363A00000X
NJ25MP00287700363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03750007Medicaid