Healthcare Provider Details

I. General information

NPI: 1801708540
Provider Name (Legal Business Name): LUMINOSAS WELLNESS COLLECTIVE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 BROADWAY STE B-1
PATERSON NJ
07514-1524
US

IV. Provider business mailing address

1971 LONG TER
UNION NJ
07083-5406
US

V. Phone/Fax

Practice location:
  • Phone: 732-718-3893
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: CATHERINE OBANDO
Title or Position: CO-EXECUTIVE DIRECTOR
Credential: MSN, NP-C
Phone: 732-718-3893