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General NPI Number Information
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NPI Number | 1952555062
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Entity Type | Organization
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Legal Business Name | CARMEN S LUCIANO DPM LLC
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Dates
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Enumeration Date | 11/17/2008
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Last Update Date | 11/17/2008
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Provider Practice Location Address
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Address Line | 324 ELM ST SUITE 101A
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City | MONROE
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State | CT
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Zip | 06468-2280
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Country | US
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Telephone | 203-261-9700
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Fax | 203-459-8974
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Provider Business Mailing Address
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Address Line | 324 ELM ST SUITE 101A
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City | MONROE
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State | CT
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Zip | 06468-2280
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Country | US
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Telephone | 203-261-9700
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Fax | 203-459-8974
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Authorized Official
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Title or Position | OWNER
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Name | DR. CARMEN S LUCIANO
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Credential | DPM
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Telephone | 203-261-9700
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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 | CT000115
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License Number State | CT
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