Provider Demographics
NPI:1740424035
Name:YI, LUSIA S (DO, MS, FAOCD)
Entity type:Individual
Prefix:DR
First Name:LUSIA
Middle Name:S
Last Name:YI
Suffix:
Gender:F
Credentials:DO, MS, FAOCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 FRIENDS LN STE 115
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1885
Mailing Address - Country:US
Mailing Address - Phone:609-799-1600
Mailing Address - Fax:267-358-5166
Practice Address - Street 1:11 FRIENDS LN STE 115
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1885
Practice Address - Country:US
Practice Address - Phone:609-799-1600
Practice Address - Fax:267-358-5166
Is Sole Proprietor?:No
Enumeration Date:2009-04-30
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014982207N00000X
NJ25MB09666500207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology