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Organization

LUZATO MEDICAL GROUP P.C.

Active
Other names
College Point Medical Group
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JACK BRUDER M.D. (PRESIDENT)
(718) 461-9105
Entity
Organization

Contact information

Practice address
1812 COLLEGE POINT BLVD, COLLEGE POINT, NY 11356-2221
(718) 461-9105
(716) 461-3392
Mailing address
1812 COLLEGE POINT BLVD, COLLEGE POINT, NY 11356-2221
(718) 461-9105
(716) 461-3392

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
207RC0000X
Cardiovascular Disease Physician
207RG0100X
Gastroenterology Physician
Primary
208800000X
Urology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5501024
GHI
NY
Enumeration date
01/23/2007
Last updated
09/11/2025
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