MEDICARE: LUMINA CARE MEDICAL GROUP PA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician
3	2084B0040X	Behavioral Neurology & Neuropsychiatry Physician
4	207P00000X	Emergency Medicine Physician
5	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1770443632
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUMINA CARE MEDICAL GROUP PA

Provider Business Mailing Address
First Line	:	885 3RD AVE FL 28
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-4834
Country	:	US
Telephone Number	:	929-650-3990
Fax Number	:	929-996-6230

Provider Business Practice Location Address
First Line	:	885 3RD AVE FL 28
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-4834
Country	:	US
Telephone Number	:	929-650-3990
Fax Number	:	929-996-6230

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	FAIGA MILLER
Credential	:
Telephone Number	:	929-650-3990

Provider Enumeration Date	:	11/13/2025
Last Update Date	:	06/04/2026

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Directions to “LUMINA CARE MEDICAL GROUP PA ” Practice Location

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