Provider Demographics
NPI:1922635531
Name:LUMIRI SURGICAL LLC
Entity Type:Organization
Organization Name:LUMIRI SURGICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:ANN PIERCE
Authorized Official - Last Name:SCHATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-241-0420
Mailing Address - Street 1:10325 KENSINGTON PKWY UNIT 432
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-7519
Mailing Address - Country:US
Mailing Address - Phone:240-241-0420
Mailing Address - Fax:862-298-0732
Practice Address - Street 1:8116 GOOD LUCK RD STE 215
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3508
Practice Address - Country:US
Practice Address - Phone:240-241-0420
Practice Address - Fax:862-298-0732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-24
Last Update Date:2020-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty