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General NPI Number Information
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NPI Number | 1972399582
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Entity Type | Organization
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Legal Business Name | LUMINARY CARE OF NY LLC
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Dates
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Enumeration Date | 04/18/2025
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 4212 28TH ST APT 42C
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-6253
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Country | US
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Telephone | 347-837-2088
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Fax |
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Provider Business Mailing Address
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Address Line | 1280 LEXINGTON AVE FRONT 2 #1234
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City | NEW YORK
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State | NY
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Zip | 10028
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Country | US
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Telephone | 347-837-2088
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | SHAIFUL CHOWDHURY
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Credential |
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Telephone | 347-837-2088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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