| Lumina Psychiatry Group Llc | |
|
833 Lacey Rd Ste 6 Forked River NJ 08731-1200 | |
| (201) 614-5900 | |
| (201) 366-6690 |
| Full Name | Lumina Psychiatry Group Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 833 Lacey Rd Ste 6, Forked River, New Jersey |
| Authorized Official Name and Position | Daniel Bhagat (CEO) |
| Authorized Official Contact | 2016145900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lumina Psychiatry Group Llc Po Box 7903 Philadelphia PA 19101-7903 Ph: () - | Lumina Psychiatry Group Llc 833 Lacey Rd Ste 6 Forked River NJ 08731-1200 Ph: (201) 614-5900 |
| NPI Number | 1720846496 |
|---|---|
| Provider Enumeration Date | 03/07/2024 |
| Last Update Date | 03/07/2024 |
| Certification Date | 03/07/2024 |
| Medicare PECOS PAC ID | 1254779135 |
|---|---|
| Medicare Enrollment ID | O20240411000861 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720846496 | NPI | - | NPPES |
| Provider Name | Marie Garon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508391046 PECOS PAC ID: 8022385699 Enrollment ID: I20170602000141 |
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