Provider Demographics
NPI:1558453225
Name:LUNA, LUIS F (MD)
Entity Type:Individual
Prefix:MR
First Name:LUIS
Middle Name:F
Last Name:LUNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 6TH AVE FL 1ER
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07524-1241
Mailing Address - Country:US
Mailing Address - Phone:973-782-5550
Mailing Address - Fax:973-782-5548
Practice Address - Street 1:185 6TH AVE FL 1ER
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07524-1241
Practice Address - Country:US
Practice Address - Phone:973-782-5550
Practice Address - Fax:973-782-5548
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07806100207R00000X
MA213295207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
213295OtherTUFTS
NJ0140210Medicaid
NJP00390912OtherRAILROAD MEDICARE#
M19070OtherGROUP BCBS
M19070OtherGROUP BCBS
NJ090662PWSMedicare PIN
NJP00390912OtherRAILROAD MEDICARE#
MA0183741Medicaid