Provider Demographics
NPI:1700975851
Name:LUI, IRENE MAE (OD)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:MAE
Last Name:LUI
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 1:44 NEWARK ST
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-5611
Mailing Address - Country:US
Mailing Address - Phone:201-683-4228
Mailing Address - Fax:201-683-4230
Practice Address - Street 1:44 NEWARK ST
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5611
Practice Address - Country:US
Practice Address - Phone:201-683-4228
Practice Address - Fax:201-683-4230
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006794152W00000X
NJ27OA00606900152W00000X
NJ27OA00606901152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ234582YGLJMedicare PIN
NJ234582YG6VMedicare PIN