MEDICARE: DR LUIS F LUNA MD LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	302R00000X	Health Maintenance Organization	25MA07806100	NJ

General Provider Information

NPI Number	:	1639403546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR LUIS F LUNA MD LLC

Provider Business Mailing Address
First Line	:	P.O.BOX 4167
Second Line	:
City	:	RIVER EDGE
State	:	NJ
Zip	:	07661
Country	:	US
Telephone Number	:	201-543-9992
Fax Number	:	201-227-9509

Provider Business Practice Location Address
First Line	:	34 MILL ST
Second Line	:
City	:	PATERSON
State	:	NJ
Zip	:	07501-1825
Country	:	US
Telephone Number	:	201-543-9992
Fax Number	:	201-227-9509

Authorized Official
Title or Position	:	PRINCIPAL
Name	:	DR. LUIS F LUNA
Credential	:	MD
Telephone Number	:	201-543-9992

Provider Enumeration Date	:	09/24/2009
Last Update Date	:	09/24/2009

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