MEDICARE: ANGELA AIYAN LU NP

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	363LF0000X	Family Nurse Practitioner	A175916	IA
2	363L00000X	Nurse Practitioner	A175916	IA
3	363LF0000X	Family Nurse Practitioner	348349	NY

General Provider Information

NPI Number	:	1336816123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA AIYAN LU NP

Provider Business Mailing Address
First Line	:	200 HAWKINS DR
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52242-1009
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5115 7TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-2806
Country	:	US
Telephone Number	:	718-851-8928
Fax Number	:

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

Provider Enumeration Date	:	08/27/2021
Last Update Date	:	11/18/2025

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