MEDICARE: DR. DAVID P LUONGO DPM

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	213E00000X	Podiatrist	N005487-1	NY
2	213E00000X	Podiatrist	MD002517	NJ

General Provider Information

NPI Number	:	1700872397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID P LUONGO DPM

Provider Business Mailing Address
First Line	:	85 STELLING AVE
Second Line	:
City	:	MAYWOOD
State	:	NJ
Zip	:	07607-2135
Country	:	US
Telephone Number	:	201-784-1900
Fax Number	:	201-784-8785

Provider Business Practice Location Address
First Line	:	10 MCKINLEY ST STE 15
Second Line	:
City	:	CLOSTER
State	:	NJ
Zip	:	07624-2726
Country	:	US
Telephone Number	:	201-784-1900
Fax Number	:	201-784-8785

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	08/31/2023

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Directions to “ DR. DAVID P LUONGO DPM” Practice Location

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