Healthcare Provider Details

I. General information

NPI: 1902130628
Provider Name (Legal Business Name): YONG LUO M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2009
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3808 UNION ST STE 7C
FLUSHING NY
11354-5672
US

IV. Provider business mailing address

3808 UNION ST STE 7C
FLUSHING NY
11354-5672
US

V. Phone/Fax

Practice location:
  • Phone: 718-475-9606
  • Fax: 718-475-9607
Mailing address:
  • Phone: 718-886-2828
  • Fax: 718-475-9607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberME174357
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number267414
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: