Provider Demographics
NPI:1871910034
Name:LUO, LAI (LAC)
Entity type:Individual
Prefix:
First Name:LAI
Middle Name:
Last Name:LUO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:LUO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:752 W END AVE APT 6H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6231
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19 W 21ST ST RM 904
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6851
Practice Address - Country:US
Practice Address - Phone:917-677-5751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005181171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist