Provider Demographics
NPI:1417274457
Name:ANTHONY L LUCIANO, M.D., P.C.
Entity Type:Organization
Organization Name:ANTHONY L LUCIANO, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANTHONY L LUCIANO M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:LUCIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-365-5050
Mailing Address - Street 1:450 PLANDOME RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-1937
Mailing Address - Country:US
Mailing Address - Phone:516-365-5050
Mailing Address - Fax:516-869-9894
Practice Address - Street 1:450 PLANDOME RD
Practice Address - Street 2:SUITE 103
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-1937
Practice Address - Country:US
Practice Address - Phone:516-365-5050
Practice Address - Fax:516-869-9894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY158971261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA61653Medicare UPIN