MEDICARE: HUILING LU RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	625130	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	796483974	OTHER	NY	ID

General Provider Information

NPI Number	:	1063896173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUILING LU RN

Provider Business Mailing Address
First Line	:	1951 W 4TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-2706
Country	:	US
Telephone Number	:	917-528-8098
Fax Number	:

Provider Business Practice Location Address
First Line	:	1951 W 4TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-2706
Country	:	US
Telephone Number	:	917-528-8098
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2015
Last Update Date	:	07/17/2015

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