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Individual

EDWIN LUCIANO JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
506 SIXTH STREET, THE METHODIST HOSPITAL, BROOKLYN, NY 11215
(718) 780-3159
(610) 617-6280
Mailing address
506 6TH ST, BROOKLYN, NY 11215-3609
(800) 666-2455
(610) 617-6280

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005106
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01855389
NY
Enumeration date
06/07/2006
Last updated
11/20/2023
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