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General NPI Number Information
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NPI Number | 1821860230
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Entity Type | Individual
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Provider Name | GINA LUCIANO
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Gender | Female
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Dates
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Enumeration Date | 10/30/2023
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Last Update Date | 10/30/2023
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Provider Practice Location Address
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Address Line | 101 NORTHERN BLVD
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City | GREENVALE
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State | NY
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Zip | 11548-1340
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Country | US
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Telephone | 516-629-2014
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Fax |
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Provider Business Mailing Address
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Address Line | 38 STRATFORD RD
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City | WEST HEMPSTEAD
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State | NY
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Zip | 11552-1724
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Country | US
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Telephone | 516-232-6779
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 311230
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License Number State | NY
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