Healthcare Provider Details

I. General information

NPI: 1225755242
Provider Name (Legal Business Name): OSWALDO ALBERTO LUCIANO NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2022
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1468 MADISON AVE # 1144
NEW YORK NY
10029-6508
US

IV. Provider business mailing address

169 MADISON AVE STE 15555
NEW YORK NY
10016-5101
US

V. Phone/Fax

Practice location:
  • Phone: 646-379-6877
  • Fax:
Mailing address:
  • Phone: 646-761-4843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number658054
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number356335
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: