Individual
LUC LANDRY SUMO KOUATCHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
355 BARD AVE, STATEN ISLAND, NY 10310-1664
(718) 818-1645
Mailing address
288 KISSEL AVE APT 2D, STATEN ISLAND, NY 10310-1636
(240) 491-1319
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
NY
Other
Enumeration date
06/30/2025
Last updated
06/30/2025
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