Provider Demographics
NPI:1558048421
Name:DELUCA, BRENDA J
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:J
Last Name:DELUCA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4451 PERRY CIR
Mailing Address - Street 2:
Mailing Address - City:SEVEN HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44131-5946
Mailing Address - Country:US
Mailing Address - Phone:216-372-0654
Mailing Address - Fax:
Practice Address - Street 1:4451 PERRY CIR
Practice Address - Street 2:
Practice Address - City:SEVEN HILLS
Practice Address - State:OH
Practice Address - Zip Code:44131-5946
Practice Address - Country:US
Practice Address - Phone:216-372-0654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant