Healthcare Provider Details

I. General information

NPI: 1992949283
Provider Name (Legal Business Name): LYNETTE C. LUZ N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2009
Last Update Date: 04/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GUSTAVE L. LEVY PLACE
NEW YORK NY
10029
US

IV. Provider business mailing address

1 GUSTAVE L. LEVY PLACE
NEW YORK NY
10029
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-6500
  • Fax: 212-348-0977
Mailing address:
  • Phone: 212-241-8095
  • Fax: 212-348-0977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number430208
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: