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General NPI Number Information
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NPI Number | 1447239413
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Entity Type | Individual
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Provider Name | DANIELLE ELIZABETH LUCIANO M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/10/2006
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Last Update Date | 11/07/2022
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Provider Practice Location Address
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Address Line | 1115 WEST ST 2ND FLOOR
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City | SOUTHINGTON
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State | CT
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Zip | 06489-6025
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Country | US
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Telephone | 860-276-6043
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Fax | 860-276-6059
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Provider Business Mailing Address
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Address Line | 263 FARMINGTON AVE PROVIDER ENROLLMENT
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City | FARMINGTON
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State | CT
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Zip | 06030-2212
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Country | US
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Telephone | 860-679-2792
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Fax | 860-679-1494
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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 | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 043408
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License Number State | CT
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