MEDICARE: CHRISTOPHER LJUCOVIC FNP

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	363LF0000X	Family Nurse Practitioner	346167	NY

General Provider Information

NPI Number	:	1942578968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER LJUCOVIC FNP

Provider Business Mailing Address
First Line	:	3030 47TH AVE STE 635
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-3492
Country	:	US
Telephone Number	:	718-472-1999
Fax Number	:	718-472-5222

Provider Business Practice Location Address
First Line	:	3030 47TH AVE STE 635
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-3492
Country	:	US
Telephone Number	:	718-472-1999
Fax Number	:	718-472-5222

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

Provider Enumeration Date	:	12/05/2011
Last Update Date	:	08/19/2025

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