Healthcare Provider Details
I. General information
NPI: 1003779158
Provider Name (Legal Business Name): YAN TO LUI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
118-120 BAXTER STREET
NEW YORK NY
10013
US
IV. Provider business mailing address
118-120 BAXTER STREET
NEW YORK NY
10013
US
V. Phone/Fax
- Phone: 212-226-1353
- Fax: 212-202-3538
- Phone: 212-226-1353
- Fax: 212-202-3538
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: