Healthcare Provider Details

I. General information

NPI: 1932003241
Provider Name (Legal Business Name): DUSTIN LUU RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 CHAPEL AVE W STE 501
CHERRY HILL NJ
08002-2059
US

IV. Provider business mailing address

2211 CHAPEL AVE W STE 501
CHERRY HILL NJ
08002-2059
US

V. Phone/Fax

Practice location:
  • Phone: 856-922-5180
  • Fax: 215-521-6194
Mailing address:
  • Phone: 856-922-5180
  • Fax: 215-521-6194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR18761400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: