Provider Demographics
NPI:1467451625
Name:TREDICI, LUCIA (MD)
Entity Type:Individual
Prefix:DR
First Name:LUCIA
Middle Name:
Last Name:TREDICI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 N ALMA SCHOOL RD
Mailing Address - Street 2:SUITE # 18
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-2866
Mailing Address - Country:US
Mailing Address - Phone:480-899-0188
Mailing Address - Fax:480-899-0199
Practice Address - Street 1:2055 N ALMA SCHOOL RD
Practice Address - Street 2:SUITE # 18
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-2866
Practice Address - Country:US
Practice Address - Phone:480-899-0188
Practice Address - Fax:480-899-0199
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMD19035207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ18WCHFH03Medicare ID - Type UnspecifiedMEDICARE B PROVIDER NIMBE
AZA29727Medicare UPIN