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General NPI Number Information
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NPI Number | 1164274254
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Entity Type | Individual
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Provider Name | I JU LUI RN
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Gender | Female
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Dates
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Enumeration Date | 04/03/2024
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Last Update Date | 04/03/2024
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Provider Practice Location Address
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Address Line | 100 E 77TH ST
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City | NEW YORK
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State | NY
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Zip | 10075-1850
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Country | US
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Telephone | 212-434-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 3916 205TH ST FL 2
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City | BAYSIDE
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State | NY
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Zip | 11361-2631
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Country | US
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Telephone | 917-215-8727
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 793239
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 793239
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 793239
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License Number State | NY
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