MEDICARE: LUTHER KNANISHU

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	1041C0700X	Clinical Social Worker	089859	NY

General Provider Information

NPI Number	:	1386075372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUTHER KNANISHU

Provider Business Mailing Address
First Line	:	957 GREENE AVE APT A5
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11221-2948
Country	:	US
Telephone Number	:	917-488-1993
Fax Number	:

Provider Business Practice Location Address
First Line	:	957 GREENE AVE APT A5
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11221-2948
Country	:	US
Telephone Number	:	917-488-1993
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2013
Last Update Date	:	05/18/2026

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Directions to “ LUTHER KNANISHU ” Practice Location

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