Healthcare Provider Details

I. General information

NPI: 1629510078
Provider Name (Legal Business Name): MRS. LAURA LUCATORTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA MARIE POZZA

II. Dates (important events)

Enumeration Date: 11/15/2016
Last Update Date: 01/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 WILSON AVE
WASHINGTON PA
15301-3336
US

IV. Provider business mailing address

155 WILSON AVE
WASHINGTON PA
15301-3336
US

V. Phone/Fax

Practice location:
  • Phone: 724-225-7000
  • Fax:
Mailing address:
  • Phone: 724-225-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN586160
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: