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General NPI Number Information
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NPI Number | 1356330914
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Entity Type | Individual
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Provider Name | VINCENT DINO LUCCHETTI OD
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Gender | Male
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 08/26/2011
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Provider Practice Location Address
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Address Line | 200 MEDICAL ARTS BLDG SUITE 210
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City | KITTANNING
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State | PA
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Zip | 16201-7132
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Country | US
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Telephone | 724-543-2146
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Fax | 724-545-9678
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Provider Business Mailing Address
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Address Line | 200 MEDICAL ARTS BLDG SUITE 210
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City | KITTANNING
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State | PA
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Zip | 16201-7132
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Country | US
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Telephone | 724-543-2146
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Fax | 724-545-9678
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0EG001016
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License Number State | PA
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