Individual
JUN LU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
21 SOUTH RD, DERMATOLOGY, FARMINGTON, CT 06032-2482
(860) 679-4600
(860) 679-1248
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT - ELLIE ATKINS, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
048382
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417099128
—
CT
Enumeration date
02/12/2007
Last updated
09/26/2022
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