Healthcare Provider Details

I. General information

NPI: 1437109790
Provider Name (Legal Business Name): LUCA RICHARD DELATORE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 TAYLOR AVE
COLUMBUS OH
43203-1779
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-257-6414
  • Fax: 614-257-3905
Mailing address:
  • Phone: 614-257-3414
  • Fax: 614-257-3905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number35083597D
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.083597
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: