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1891783650

NPI Code Detail

MEDICARE: DR. PIFU LUO MD

MEDICARE: DR. PIFU LUO MD

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	207ZC0500X	Cytopathology Physician	35575	IA
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	242210	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	36385	OTHER	IA	WELLMARK BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	36384	OTHER	IA	WELLMARK BCBS

General Provider Information

NPI Number	:	1891783650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PIFU LUO MD

Provider Business Mailing Address
First Line	:	1555 LONG POND RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14626-4122
Country	:	US
Telephone Number	:	585-368-4392
Fax Number	:	585-723-7735

Provider Business Practice Location Address
First Line	:	1555 LONG POND RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14626-4122
Country	:	US
Telephone Number	:	585-368-4392
Fax Number	:	585-723-7735

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

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	04/29/2009

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Directions to “ DR. PIFU LUO MD” Practice Location

Language	Start Address	Practice Location

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