| Jenny Q. Lu, M.d., Pllc | |
|
75 Crystal Run Rd Ste 105 Middletown NY 10941-7003 | |
| (845) 692-3542 | |
| (845) 692-6939 |
| Full Name | Jenny Q. Lu, M.d., Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 75 Crystal Run Rd Ste 105, Middletown, New York |
| Authorized Official Name and Position | Jenny Q Lu (OWNER) |
| Authorized Official Contact | 8456923542 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jenny Q. Lu, M.d., Pllc 75 Crystal Run Rd Ste 105 Middletown NY 10941-7003 Ph: (845) 692-3542 | Jenny Q. Lu, M.d., Pllc 75 Crystal Run Rd Ste 105 Middletown NY 10941-7003 Ph: (845) 692-3542 |
| NPI Number | 1053542068 |
|---|---|
| Provider Enumeration Date | 08/07/2009 |
| Last Update Date | 07/06/2010 |
| Medicare PECOS PAC ID | 6608904404 |
|---|---|
| Medicare Enrollment ID | O20100517000004 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053542068 | NPI | - | NPPES |
| 01999279 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 214481 (New York) | Primary |
| Provider Name | Jenny Q Lu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396784070 PECOS PAC ID: 9931117116 Enrollment ID: I20060329000646 |
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