Provider Demographics
NPI:1003982158
Name:DELROSARIO, LUCELLE M (MD)
Entity type:Individual
Prefix:
First Name:LUCELLE
Middle Name:M
Last Name:DELROSARIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:161 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743
Mailing Address - Country:US
Mailing Address - Phone:631-427-3300
Mailing Address - Fax:631-427-3412
Practice Address - Street 1:161 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743
Practice Address - Country:US
Practice Address - Phone:631-427-3300
Practice Address - Fax:631-427-3422
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1624361207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
67D411OtherNO BLUE CHOICE SR PLAN
SF0000406OtherAFFORDABLE NETWORKS
SF0000406OtherSELECT PRO
67D411OtherBLUE CHOICE HMP POS PPO
2C4141OtherHEALTHNET FORMERLY PHS
67D4111OtherBLUE CROSS FEDERAL EMPLOY
NY00961679Medicaid
2263840OtherAETNA US HEALTHCARE
672521OtherEMPIRE PLAN UNITED HLTHCA
4199010OtherAETNA PPO MANAGED CHOICE
CP684OtherOXFORD HLTH PLNS & ADVTGE
13254OtherNYTRA NO SMART CHOICE
49801OtherNO CIGNA HMP POS PPO
CP684OtherOXFORD LIBERTY PLAN
SF0000406OtherFIRST HEALTH HLTH CARE CO
AF01086OtherMDNY NO FOCUS
13254OtherNYTRA NO SMART CHOICE
SF0000406OtherSELECT PRO
672521OtherEMPIRE PLAN UNITED HLTHCA