Provider Demographics
NPI:1760443030
Name:LUCATORTO, ANTHONY JOSEPH (DO)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:LUCATORTO
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:694 STATE ROUTE 15 S
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LAKE HOPATCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07849-2249
Mailing Address - Country:US
Mailing Address - Phone:973-663-8899
Mailing Address - Fax:973-663-9511
Practice Address - Street 1:694 ROUTE15 SOUTH
Practice Address - Street 2:SUITE 103
Practice Address - City:LAKE HOPATCONG
Practice Address - State:NJ
Practice Address - Zip Code:07849-2249
Practice Address - Country:US
Practice Address - Phone:973-663-8899
Practice Address - Fax:973-663-9511
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2013-07-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMB60950207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ200563432OtherUNITED HEALTHCARE ID
NJ200563432OtherQUALCARE PPO HMO ID
NJ2355303001OtherAMERIHEALTH HMO
NJ0811246000OtherAMERIHEALTH HMO
NJ200563432OtherBCBS FEDERAL EMPLOYEE
NJ000786118OtherHIGHMARK BLUE SHIELD ID
NJP376680OtherOXFORD HEALTH PLAN ID
NJP376680OtherOXFORD HEALTH PLAN ID
NJ200563432OtherUNITED HEALTHCARE ID
NJP00257832DD8843Medicare ID - Type UnspecifiedRAILROAD MEDICARE