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LUCKY CARE MEDICAL, PC
NPI 1174796650
Internal Medicine in New York, NY

Active since April 07, 2008
2108 2ND AVE, NEW YORK, NY 10029(212) 876-8590(212) 360-1844 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 7, 2023, Jun 21, 2018 (2 updates tracked since 2018).

About Lucky Care Medical, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LUCKY CARE MEDICAL, PC (NPI 1174796650) is a healthcare organization registered as an internal medicine in New York, New York and active in the NPI registry since April 2008. The organization lists Clyde Lucky, President, as its authorized official.

NPPES Registry Identity

NPI1174796650
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameLUCKY CARE MEDICAL, PC
Location Address2108 2ND AVENew York, NY 10029-3731
Mailing Address13876 Queens Blvd Fl 1Briarwood, NY 11435-2930 · (718) 850-6345 · Fax (718) 559-4895
Phone(212) 876-8590
Fax(212) 360-1844
Organization SubpartNo
Authorized OfficialClyde LuckyPresident · (212) 876-8590
Enumeration DateApril 7, 2008
Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration
✔ NPI 1174796650 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NY · 167799
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2108 2ND AVE, New York, NY 10029
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Other Identifiers 1

Medicaid01029056NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lucky Care Medical, PC's NPI number?

The NPI number for Lucky Care Medical, PC is 1174796650. It was assigned to this organization in the NPPES registry on April 7, 2008.

Where is Lucky Care Medical, PC located?

Lucky Care Medical, PC is located at 2108 2nd Ave, New York, NY 10029. The listed phone number is (212) 876-8590.

What is Lucky Care Medical, PC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

When was this NPI record last updated?

The NPPES record for Lucky Care Medical, PC was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.