MEDICARE: LILIANE LONH LUONG RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	040497	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	040497	OTHER	NY	RPH

General Provider Information

NPI Number	:	1033241328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILIANE LONH LUONG RPH

Provider Business Mailing Address
First Line	:	28 TIOGA DR
Second Line	:
City	:	JERICHO
State	:	NY
Zip	:	11753-1930
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	28 TIOGA DR
Second Line	:
City	:	JERICHO
State	:	NY
Zip	:	11753-1930
Country	:	US
Telephone Number	:	212-423-6164
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	07/08/2007

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