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General NPI Number Information
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NPI Number | 1306305420
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Entity Type | Organization
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Legal Business Name | DR ANMING LUO PHYSICIAN PC
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 03/18/2019
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Provider Practice Location Address
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Address Line | 821 57TH ST
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City | BROOKLYN
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State | NY
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Zip | 11220-3645
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Country | US
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Telephone | 718-436-3088
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Fax | 718-436-5929
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Provider Business Mailing Address
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Address Line | 1722 85TH ST
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City | BROOKLYN
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State | NY
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Zip | 11214-2820
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Country | US
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Telephone | 718-436-3088
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Fax | 718-436-5929
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANMING LUO
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Credential | MD
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Telephone | 718-436-3088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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