Provider Demographics
NPI:1922801232
Name:OCCHINO-MOEDE, LUCAS
Entity type:Individual
Prefix:
First Name:LUCAS
Middle Name:
Last Name:OCCHINO-MOEDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:LUCAS
Other - Middle Name:
Other - Last Name:OCCHINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3535 MARKET ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3377
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3535 MARKET ST STE 200
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3377
Practice Address - Country:US
Practice Address - Phone:215-662-3957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program