MEDICARE: DR. RALPH JOHN LUCIANI I D.O., M.D.(H)

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	1080	AZ

General Provider Information

NPI Number	:	1003091117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RALPH JOHN LUCIANI I D.O., M.D.(H)

Provider Business Mailing Address
First Line	:	1530 W GLENDALE AVE
Second Line	:	SUITE 106
City	:	PHOENIX
State	:	AZ
Zip	:	85021-8578
Country	:	US
Telephone Number	:	602-242-4024
Fax Number	:	602-242-4913

Provider Business Practice Location Address
First Line	:	1530 W GLENDALE AVE
Second Line	:	SUITE 106
City	:	PHOENIX
State	:	AZ
Zip	:	85021-8578
Country	:	US
Telephone Number	:	602-242-4024
Fax Number	:	602-242-4913

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2008
Last Update Date	:	01/08/2008

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