Provider Demographics
NPI:1609826189
Name:LUCA, ROBERT PETER (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:PETER
Last Name:LUCA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:PETER
Other - Last Name:LUCA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:P.O. BOX 4258
Mailing Address - Street 2:
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10163
Mailing Address - Country:US
Mailing Address - Phone:845-343-9600
Mailing Address - Fax:
Practice Address - Street 1:453 ROUTE 211 EAST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940
Practice Address - Country:US
Practice Address - Phone:845-343-9600
Practice Address - Fax:845-343-9614
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX00522111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0006849OtherGHI
NY113396095 0006OtherCIGNA
NY172908OtherELDERPLAN
NYCO-5220-1BOtherWORKERS COMP
NY01898195Medicaid
NY06458HMedicaid
NY113322995OtherHORIZON
NYN35889OtherHEALTH NET
NYX28342OtherEMPIRE BC/BS
NY4276640OtherAETNA
NY11-3396095-03Other1199
NYX005220OtherHIP
NY00002817003OtherUNITED HEALTH CARE NY
NY1054398OtherAMERICAN SPECIALTY HEALTH
NYP630839OtherOXFORD
NY06458HMedicaid
NYX005220OtherHIP
NY00002817003OtherUNITED HEALTH CARE NY