Provider Demographics
NPI:1437152337
Name:LUCCA, JOSEPH A (PT, PHD, GCS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:LUCCA
Suffix:
Gender:M
Credentials:PT, PHD, GCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2806 BAYNARD BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-2968
Mailing Address - Country:US
Mailing Address - Phone:302-750-1258
Mailing Address - Fax:302-831-4234
Practice Address - Street 1:2806 BAYNARD BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-2968
Practice Address - Country:US
Practice Address - Phone:302-750-1258
Practice Address - Fax:302-831-4234
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2010-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-00001482251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE119977Medicare PIN