Healthcare Provider Details

I. General information

NPI: 1891593653
Provider Name (Legal Business Name): LUMINARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4212 28TH ST APT 42C
LONG ISLAND CITY NY
11101-6253
US

IV. Provider business mailing address

347 BRADFORD ST
BROOKLYN NY
11207-4206
US

V. Phone/Fax

Practice location:
  • Phone: 347-837-2088
  • Fax:
Mailing address:
  • Phone: 347-837-2088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: SHAIFUL CHOWDHURY
Title or Position: FOUNDER
Credential: BUSINESS OWNER
Phone: 347-837-2088