Healthcare Provider Details

I. General information

NPI: 1720846496
Provider Name (Legal Business Name): LUMINA PSYCHIATRY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2024
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 LACEY RD STE 6
FORKED RIVER NJ
08731-1200
US

IV. Provider business mailing address

PO BOX 7903
PHILADELPHIA PA
19101-7903
US

V. Phone/Fax

Practice location:
  • Phone: 201-614-5900
  • Fax: 201-366-6690
Mailing address:
  • Phone: 201-614-5900
  • Fax: 201-366-6690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES REICHMAN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 201-614-5900