Provider Demographics
NPI:1558602649
Name:NINAMARIE LUCCHINI, LLC
Entity Type:Organization
Organization Name:NINAMARIE LUCCHINI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL INSTRUCTOR
Authorized Official - Prefix:
Authorized Official - First Name:NINAMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCCHINI
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:347-242-0648
Mailing Address - Street 1:124 HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-1348
Mailing Address - Country:US
Mailing Address - Phone:347-242-0648
Mailing Address - Fax:
Practice Address - Street 1:124 HARVARD AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-1348
Practice Address - Country:US
Practice Address - Phone:347-242-0648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty