Lum, John
Lum, John is an individual health care provider with primary practice located at 1389 W Main St , Waterbury CT 06708-3104. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Lum, John can be contacted via phone (203) 755-5555.Contact Information
Primary practice address
1389 W Main St
Waterbury CT 06708-3104
Phone: (203) 755-5555
Fax: (203) 573-8523
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 000669 | Connecticut |
Profile Details
| NPI number | 1528016441 |
|---|---|
| LBN Legal business name | Lum, John |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 4th, 2006 |
| Last updated | Dec 22nd, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528016441 | NPPES |
| Connecticut | MEDICAID | 004085636 |
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