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NPI Code Detail

MEDICARE: DR. CHAD LUE D.O.

MEDICARE: DR. CHAD LUE D.O.
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207Q00000XFamily Medicine Physician287192NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1287192OTHERNYNYS LICENSE

General Provider Information

NPI Number : 1427461417
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHAD LUE D.O.
Provider Business Mailing Address
First Line : 129 W 29TH ST FL 10
Second Line :
City : NEW YORK
State : NY
Zip : 10001-5105
Country : US
Telephone Number : 415-658-6791
Fax Number : 415-520-0904
Provider Business Practice Location Address
First Line : 919 3RD AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10022-3902
Country : US
Telephone Number : 888-663-6331
Fax Number : 415-252-7176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2014
Last Update Date : 03/19/2025

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