Provider Demographics
NPI:1508134669
Name:LUCIANI-LOPEZ, MARIA N (LMT, LAC)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:N
Last Name:LUCIANI-LOPEZ
Suffix:
Gender:F
Credentials:LMT, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 CASTLE AVE
Mailing Address - Street 2:SUITE 2G
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-2025
Mailing Address - Country:US
Mailing Address - Phone:516-459-4033
Mailing Address - Fax:
Practice Address - Street 1:293 CASTLE AVE
Practice Address - Street 2:SUITE 2G
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-2025
Practice Address - Country:US
Practice Address - Phone:516-459-4033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-05
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000846-1171100000X
NY005561-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No171100000XOther Service ProvidersAcupuncturist