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NPI Code Detail

MEDICARE: DR. LU FAN PHARM D.

MEDICARE: DR. LU FAN PHARM D.
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
1183500000XPharmacist057846NY

General Provider Information

NPI Number : 1548501836
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LU FAN PHARM D.
Provider Business Mailing Address
First Line : 6827 KESSEL ST
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-5729
Country : US
Telephone Number : 917-292-8300
Fax Number :
Provider Business Practice Location Address
First Line : 2125 BROADWAY
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11106-4532
Country : US
Telephone Number : 718-932-9200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2013
Last Update Date : 03/12/2013

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