MEDICARE: LUMEN MEDICAL ENDOSCOPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician

General Provider Information

NPI Number	:	1316889918
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUMEN MEDICAL ENDOSCOPY LLC

Provider Business Mailing Address
First Line	:	3808 UNION ST STE 3N
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-5670
Country	:	US
Telephone Number	:	718-886-6495
Fax Number	:	718-732-2960

Provider Business Practice Location Address
First Line	:	3808 UNION ST STE 3N
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-5670
Country	:	US
Telephone Number	:	718-886-6495
Fax Number	:	718-732-2960

Authorized Official
Title or Position	:	OWNER
Name	:	JUSTIN ZHUO
Credential	:	MD
Telephone Number	:	718-886-6495

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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Directions to “LUMEN MEDICAL ENDOSCOPY LLC ” Practice Location

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