MEDICARE: LUZATO MEDICAL GROUP, P.C.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	207RC0000X	Cardiovascular Disease Physician
3	207RG0100X	Gastroenterology Physician
4	208800000X	Urology Physician

General Provider Information

NPI Number	:	1649429382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUZATO MEDICAL GROUP, P.C.

Provider Business Mailing Address
First Line	:	50 E 42ND ST RM 508
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-5436
Country	:	US
Telephone Number	:	212-661-7003
Fax Number	:	212-661-7005

Provider Business Practice Location Address
First Line	:	50 E 42ND ST RM 508
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-5436
Country	:	US
Telephone Number	:	212-661-7003
Fax Number	:	212-661-7005

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JACK BRUDER
Credential	:	M.D.
Telephone Number	:	212-691-3066

Provider Enumeration Date	:	09/18/2008
Last Update Date	:	04/03/2024

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Directions to “LUZATO MEDICAL GROUP, P.C. ” Practice Location

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