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General NPI Number Information
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NPI Number | 1669280525
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Entity Type | Organization
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Legal Business Name | LUNA WELLNESS INC
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Dates
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Enumeration Date | 12/24/2024
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Last Update Date | 12/24/2024
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Provider Practice Location Address
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Address Line | 111 JOHN ST STE 1450
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City | NEW YORK
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State | NY
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Zip | 10038-3122
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Country | US
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Telephone | 212-240-9471
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Fax |
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Provider Business Mailing Address
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Address Line | 99 PERCY WILLIAMS DR
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City | EAST ISLIP
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State | NY
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Zip | 11730-2219
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Country | US
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Telephone | 212-240-9471
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Fax | 201-353-2926
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ELLADA TINATTI
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Credential |
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Telephone | 212-240-9471
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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