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General NPI Number Information
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NPI Number | 1225299175
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Entity Type | Individual
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Provider Name | FRED DELUCIA DPM
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Gender | Male
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 465 COLUMBUS AVE STE 140
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City | VALHALLA
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State | NY
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Zip | 10595-1376
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Country | US
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Telephone | 914-290-6360
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Fax | 914-221-4750
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Provider Business Mailing Address
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Address Line | 465 COLUMBUS AVE STE 140
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City | VALHALLA
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State | NY
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Zip | 10595-1376
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Country | US
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Telephone | 914-290-6360
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Fax | 914-221-4750
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | AN006347
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License Number State | NY
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