Individual
JUN LU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3636 MAIN ST # 2SD, FLUSHING, NY 11354-6549
(347) 345-7460
Mailing address
3636 MAIN ST # 2SD, FLUSHING, NY 11354-6549
(347) 345-9460
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
547289-1
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F305764-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04835127
—
NY
01
—
G400430032
MEDICARE
—
Enumeration date
08/24/2011
Last updated
10/25/2018
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