Provider Demographics
NPI:1053162354
Name:LUZURIAGA, JOSHUA HONASAN
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:HONASAN
Last Name:LUZURIAGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STONY BROOK MEDICINE 101 NICOLLS ROAD
Mailing Address - Street 2:DEPARTMENT OF PATHOLOGY, LEVEL 2-749
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-7025
Mailing Address - Country:US
Mailing Address - Phone:631-444-2222
Mailing Address - Fax:
Practice Address - Street 1:STONY BROOK MEDICINE 101 NICOLLS ROAD
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY, LEVEL 2-749
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-7025
Practice Address - Country:US
Practice Address - Phone:631-444-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program