Provider Demographics
NPI:1568493112
Name:DELUCCIA, WILLIAM ARTHUR JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ARTHUR
Last Name:DELUCCIA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:571 SAINT JOSEPHS BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-3230
Mailing Address - Country:US
Mailing Address - Phone:607-271-2050
Mailing Address - Fax:607-873-1244
Practice Address - Street 1:600 IVY ST STE 205
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14905-1627
Practice Address - Country:US
Practice Address - Phone:607-737-4333
Practice Address - Fax:607-737-4271
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2020-11-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD052034L207RC0000X
NY169484207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01182970Medicaid
PA001228900Medicaid
NYP00047277OtherRR MEDICARE
NYP00047277OtherRR MEDICARE
NY01182970Medicaid