Healthcare Provider Details

I. General information

NPI: 1538116645
Provider Name (Legal Business Name): YVONNE W LUI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 1ST AVE FL 2 DEPARTMENT OF RADIOLOGY
NEW YORK NY
10016-3295
US

IV. Provider business mailing address

214 E 31ST ST #1A
NEW YORK NY
10016-6330
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-5219
  • Fax: 212-263-3838
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number220894
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: