MEDICARE: YONG LUO ALLERGY AND ASTHMA P.C.

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	207K00000X	Allergy & Immunology Physician	267414	NY

General Provider Information

NPI Number	:	1093175952
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YONG LUO ALLERGY AND ASTHMA P.C.

Provider Business Mailing Address
First Line	:	13329 41ST RD
Second Line	:	SUITE 1C
City	:	FLUSHING
State	:	NY
Zip	:	11355-3670
Country	:	US
Telephone Number	:	718-475-9606
Fax Number	:	718-475-9607

Provider Business Practice Location Address
First Line	:	13329 41ST RD
Second Line	:	SUITE 1C
City	:	FLUSHING
State	:	NY
Zip	:	11355-3670
Country	:	US
Telephone Number	:	718-475-9606
Fax Number	:	718-475-9607

Authorized Official
Title or Position	:	OWNER
Name	:	YONG LUO
Credential	:	MD
Telephone Number	:	718-475-9606

Provider Enumeration Date	:	03/03/2016
Last Update Date	:	03/03/2016

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