MEDICARE: DR. KIN W LUI M.D.

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	208800000X	Urology Physician	170686-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477631315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIN W LUI M.D.

Provider Business Mailing Address
First Line	:	139 CENTRE ST
Second Line	:	ROOM 738
City	:	NEW YORK
State	:	NY
Zip	:	10013-4552
Country	:	US
Telephone Number	:	212-274-0151
Fax Number	:	212-274-0211

Provider Business Practice Location Address
First Line	:	139 CENTRE ST.
Second Line	:	ROOM 738
City	:	NEW YORK
State	:	NY
Zip	:	10013-4116
Country	:	US
Telephone Number	:	212-274-0151
Fax Number	:	212-274-0211

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	04/05/2012

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