Provider Demographics
NPI:1942250220
Name:TULUCA, LUCIANO (MD)
Entity Type:Individual
Prefix:DR
First Name:LUCIANO
Middle Name:
Last Name:TULUCA
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 1:2114 WILLIAMSBRIDGE RD
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1600
Mailing Address - Country:US
Mailing Address - Phone:347-281-8900
Mailing Address - Fax:347-281-8899
Practice Address - Street 1:2114 WILLIAMSBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1600
Practice Address - Country:US
Practice Address - Phone:347-281-8900
Practice Address - Fax:347-281-8899
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214305012081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02267361Medicaid
NYI25733Medicare UPIN
NY02267361Medicaid