Provider Demographics
NPI:1669687570
Name:DELUCA, LUANNE (OD)
Entity Type:Individual
Prefix:DR
First Name:LUANNE
Middle Name:
Last Name:DELUCA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 KULP RD E
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-3731
Mailing Address - Country:US
Mailing Address - Phone:215-343-6315
Mailing Address - Fax:
Practice Address - Street 1:195 N WEST END BLVD
Practice Address - Street 2:WALMART VISION CENTER
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-2306
Practice Address - Country:US
Practice Address - Phone:215-529-7948
Practice Address - Fax:215-529-7962
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA007444-T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist