Provider Demographics
NPI:1114915303
Name:DELUCIA, ORLANDO (MD)
Entity Type:Individual
Prefix:
First Name:ORLANDO
Middle Name:
Last Name:DELUCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 FARMINGTON AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1936
Mailing Address - Country:US
Mailing Address - Phone:860-548-7338
Mailing Address - Fax:860-524-2654
Practice Address - Street 1:399 FARMINGTON AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1936
Practice Address - Country:US
Practice Address - Phone:860-548-7338
Practice Address - Fax:860-524-2654
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT036806208200000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0368061384OtherCONNECTICARE
CTP1131448OtherOXFORD
CT010036806CT01OtherANTHEM BCBS
CT06-1406459OtherCORVEL
CT06-1406459OtherGREAT WEST HEALTHCARE
CT06-1406459OtherUNITED HEALTHCARE
CT06-1406459OtherNORTHEAST HEALTH DIRECT
MA3183033Medicaid
CT4273999 001OtherCIGNA
CT06-1406459OtherPRIVATE HEALTHCARE SYSTEM
CT0S0381OtherHEALTH NET
CT2055859OtherAETNA
CT23415OtherHEALTH NEW ENGLAND
CT001368069Medicaid
CT06-1406459OtherFOCUS
CT06-1406459OtherHMC, PPO
CT06-1406459OtherCOLONIAL COOPERATIVE CARE
CT06-1406459OtherMULTIPLAN
CT06-1406459OtherFOCUS
CT06-1406459OtherHMC, PPO