Doctor Name: | MR. JEAN PHILIPPE LUC |
NPI Number: | 1033365234 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | NP |
License Number: | F401415-1 |
Business Practice Address: | 410 Locus Ave Uniondale, NY - 11553 |
Business Phone Number: | 5164455588 |
Business Fax Number: | |
Mailing Address: | 410 Locus Ave, UNIONDALE |
State: | NY |
Postal Code: | 11553 |
Phone Number: | 5164455588 |
Fax Number: | |
NPI Enumeration Date: | 08/07/2008 |
NPI Last Update Date: | 01/30/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | F401415-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |