Provider Demographics
NPI:1235365867
Name:DELUCA, ALEXANDER FRANK (MD, MPH)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:FRANK
Last Name:DELUCA
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 CENTRAL PARK WEST - 7N
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10225-7659
Mailing Address - Country:US
Mailing Address - Phone:212-787-4464
Mailing Address - Fax:212-874-3857
Practice Address - Street 1:320 CENTRAL PARK WEST - 7N
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-7659
Practice Address - Country:US
Practice Address - Phone:212-787-4464
Practice Address - Fax:212-874-3857
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY151081207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine