Provider Demographics
NPI:1750462172
Name:ROSSETTI, LUCIANO (MD)
Entity Type:Individual
Prefix:
First Name:LUCIANO
Middle Name:
Last Name:ROSSETTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SHERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10507-2200
Mailing Address - Country:US
Mailing Address - Phone:718-430-2908
Mailing Address - Fax:
Practice Address - Street 1:ENDOCRINOLOGY - BELFER 701
Practice Address - Street 2:1300 MORRIS PARK AVENUE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-430-2908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY195425207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine