1710064829 NPI number — MRS. LUNA FRANK LCSW

Table of content: MRS. LUNA FRANK LCSW (NPI 1710064829)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710064829 NPI number — MRS. LUNA FRANK LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRANK
Provider First Name:
LUNA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710064829
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
51 LOCUST AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CEDARHURST
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11516-2313
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-295-3797
Provider Business Mailing Address Fax Number:
718-206-7083

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14437 68TH DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLUSHING
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11367-1737
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-261-6862
Provider Business Practice Location Address Fax Number:
718-206-7083
Provider Enumeration Date:
11/01/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  R043978-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01751835 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 62-42788 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 62-42788 . This is a "AETNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: P424307 . This is a "OXFORD" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1053050 . This is a "AFFINITY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 269046 . This is a "MHN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 7331659 . This is a "VALUE OPTIONS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".