Provider Demographics
NPI:1245842251
Name:LUH, JOEY (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOEY
Middle Name:
Last Name:LUH
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:
Other - Last Name:LUH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1752 FRANCIS LEWIS BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-3247
Mailing Address - Country:US
Mailing Address - Phone:718-746-9494
Mailing Address - Fax:
Practice Address - Street 1:51 N 39TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-2640
Practice Address - Country:US
Practice Address - Phone:800-789-7366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025454363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant