MEDICARE: MS. ELENA LUNA RPH

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	183500000X	Pharmacist	36940	NY

General Provider Information

NPI Number	:	1801119540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELENA LUNA RPH

Provider Business Mailing Address
First Line	:	3765 90TH ST
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-7829
Country	:	US
Telephone Number	:	718-446-2068
Fax Number	:	718-898-9505

Provider Business Practice Location Address
First Line	:	3765 90TH ST
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-7829
Country	:	US
Telephone Number	:	718-446-2068
Fax Number	:	718-898-9505

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

Provider Enumeration Date	:	03/09/2010
Last Update Date	:	04/01/2021

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