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General NPI Number Information
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NPI Number | 1336763101
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Entity Type | Organization
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Legal Business Name | MATTHEW J. DELUCA
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Dates
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Enumeration Date | 06/08/2020
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 4 ROBINHOOD DR
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City | CRANBERRY TWP
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State | PA
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Zip | 16066-4340
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Country | US
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Telephone | 724-869-1870
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Fax | 724-869-1313
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Provider Business Mailing Address
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Address Line | 400 STATE ST
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City | BADEN
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State | PA
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Zip | 15005-1737
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Country | US
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Telephone | 724-869-1870
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Fax | 724-869-1313
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Authorized Official
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Title or Position | OD/PRESIDENT
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Name | DR. MATTHEW DELUCA
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Credential | OD
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Telephone | 724-869-1870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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