Provider Demographics
NPI:1639403546
Name:DR LUIS F LUNA MD LLC
Entity Type:Organization
Organization Name:DR LUIS F LUNA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:LUNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-543-9992
Mailing Address - Street 1:P.O.BOX 4167
Mailing Address - Street 2:
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661
Mailing Address - Country:US
Mailing Address - Phone:201-543-9992
Mailing Address - Fax:201-227-9509
Practice Address - Street 1:34 MILL ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07501-1825
Practice Address - Country:US
Practice Address - Phone:201-543-9992
Practice Address - Fax:201-227-9509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07806100302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization