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General NPI Number Information
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NPI Number | 1093175952
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Entity Type | Organization
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Legal Business Name | YONG LUO ALLERGY AND ASTHMA P.C.
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Dates
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Enumeration Date | 03/03/2016
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Last Update Date | 03/03/2016
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Provider Practice Location Address
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Address Line | 13329 41ST RD SUITE 1C
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City | FLUSHING
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State | NY
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Zip | 11355-3670
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Country | US
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Telephone | 718-475-9606
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Fax | 718-475-9607
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Provider Business Mailing Address
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Address Line | 13329 41ST RD SUITE 1C
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City | FLUSHING
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State | NY
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Zip | 11355-3670
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Country | US
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Telephone | 718-475-9606
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Fax | 718-475-9607
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Authorized Official
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Title or Position | OWNER
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Name | YONG LUO
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Credential | MD
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Telephone | 718-475-9606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 267414
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License Number State | NY
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