Organization
LUMINOSITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELA GARCIA-CRUZ (PA)
(717) 609-6596
Entity
Organization
Contact information
Practice address
503 E 9TH ST, JEFFERSONVILLE, IN 47130-4018
(717) 609-6596
Mailing address
503 E 9TH ST, JEFFERSONVILLE, IN 47130-4018
(717) 609-6596
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Enumeration date
09/20/2023
Last updated
07/22/2024
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