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Organization
LUCKY CARE MEDICAL, PC
Active
Organization
LUCKY CARE MEDICAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLYDE LUCKY M.D. (PRESIDENT)
(212) 876-8590
Entity
Organization
Contact information
Practice address
2108 2ND AVE, NEW YORK, NY 10029-3731
(212) 876-8590
(212) 360-1844
Mailing address
13876 QUEENS BLVD FL 1, BRIARWOOD, NY 11435-2930
(718) 850-6345
(718) 559-4895
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
167799
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01029056
—
NY
Enumeration date
04/07/2008
Last updated
03/07/2023
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