MEDICARE: LUTHERAN MEDICAL CENTER

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	282N00000X	General Acute Care Hospital

General Provider Information

NPI Number	:	1801126099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUTHERAN MEDICAL CENTER

Provider Business Mailing Address
First Line	:	2409 E 23RD ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-2510
Country	:	US
Telephone Number	:	347-587-4899
Fax Number	:

Provider Business Practice Location Address
First Line	:	2409 E 23RD ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-2510
Country	:	US
Telephone Number	:	347-587-4899
Fax Number	:

Authorized Official
Title or Position	:	PGY1
Name	:	DR. PHILLIP WENHWEE CHU
Credential	:	M.D.,
Telephone Number	:	347-587-4899

Provider Enumeration Date	:	01/11/2010
Last Update Date	:	01/11/2010

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