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General NPI Number Information
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NPI Number | 1336439744
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Entity Type | Individual
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Provider Name | BENJAMIN B LUONG M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/19/2011
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Last Update Date | 12/04/2018
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Provider Practice Location Address
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Address Line | 117 FOOTE AVE
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City | JAMESTOWN
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State | NY
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Zip | 14701-6947
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Country | US
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Telephone | 716-338-9200
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Fax | 716-338-9250
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Provider Business Mailing Address
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Address Line | 3085 HARLEM RD STE 350
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City | CHEEKTOWAGA
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State | NY
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Zip | 14225-2591
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Country | US
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Telephone | 716-844-5600
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Fax | 716-844-5750
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 284342
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License Number State | NY
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