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General NPI Number Information
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NPI Number | 1619503877
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Entity Type | Individual
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Provider Name | JANET LUI-TANKERSLEY PA
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Gender | Female
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Dates
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Enumeration Date | 03/19/2020
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Last Update Date | 03/19/2020
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Provider Practice Location Address
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Address Line | 525 E 68TH ST
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City | NEW YORK
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State | NY
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Zip | 10065-4870
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Country | US
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Telephone | 212-746-4547
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Fax |
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Provider Business Mailing Address
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Address Line | 190 KIRKWOOD RD NE APT D3
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City | ATLANTA
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State | GA
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Zip | 30317-1126
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Country | US
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Telephone | 678-677-4791
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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