Healthcare Provider Details

I. General information

NPI: 1316280217
Provider Name (Legal Business Name): LUCA ZATREANU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2013
Last Update Date: 04/06/2021
Certification Date: 04/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10160 BUSTLETON AVE
PHILADELPHIA PA
19116
US

IV. Provider business mailing address

5001 FRANKFORD AVE
PHILADELPHIA PA
19124-2619
US

V. Phone/Fax

Practice location:
  • Phone: 215-533-9000
  • Fax: 215-934-6278
Mailing address:
  • Phone: 215-288-5000
  • Fax: 215-744-1233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number25MA10368500
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number306733
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: