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NPI Code Detail

MEDICARE: JING LUO

MEDICARE: JING LUO
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
1101YM0800XMental Health Counselor017842NY

General Provider Information

NPI Number : 1275417016
Entity Type Code : Individual
Provider Name (Legal Business Name) : JING LUO
Provider Business Mailing Address
First Line : 2810 JACKSON AVE APT 19M
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11101-3146
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 14015B SANFORD AVE FL 2
Second Line :
City : FLUSHING
State : NY
Zip : 11355-2557
Country : US
Telephone Number : 315-413-9070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2025
Last Update Date : 05/05/2026

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Directions to “ JING LUO ” Practice Location

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