Provider Demographics
NPI:1316346281
Name:LUO, TRACY
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:LUO
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:TRACY
Other - Middle Name:
Other - Last Name:LUO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:50 BROADWAY
Mailing Address - Street 2:MHA
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-1607
Mailing Address - Country:US
Mailing Address - Phone:212-614-6334
Mailing Address - Fax:
Practice Address - Street 1:50 BROADWAY
Practice Address - Street 2:MHA
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-1607
Practice Address - Country:US
Practice Address - Phone:212-614-6334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-17
Last Update Date:2014-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker