Provider Demographics
NPI:1104213628
Name:LUCE RESPIRATORY THERAPY PLLC
Entity Type:Organization
Organization Name:LUCE RESPIRATORY THERAPY PLLC
Other - Org Name:LUCE MEDICAL & RESPIRATORY CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTINY
Authorized Official - Middle Name:
Authorized Official - Last Name:ST JUSTE
Authorized Official - Suffix:
Authorized Official - Credentials:RRT, BS
Authorized Official - Phone:631-880-0961
Mailing Address - Street 1:15 MILLET ST
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-8105
Mailing Address - Country:US
Mailing Address - Phone:631-880-0961
Mailing Address - Fax:631-714-6000
Practice Address - Street 1:139 N 17TH ST
Practice Address - Street 2:
Practice Address - City:WHEATLEY HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11798-1816
Practice Address - Country:US
Practice Address - Phone:631-880-0961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-22
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0041632279H0200X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome HealthGroup - Single Specialty
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & SuppliesGroup - Single Specialty