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NPI Code Detail

MEDICARE: DR. VINCENT J LUVERA DO

MEDICARE: DR. VINCENT J LUVERA DO
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
1207QG0300XGeriatric Medicine (Family Medicine) Physician180500-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1016672OTHEREMPIRE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3100056652606OTHERCDPHP
4000406638001OTHERBLUES
5784649OTHERMVP

General Provider Information

NPI Number : 1720072465
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VINCENT J LUVERA DO
Provider Business Mailing Address
First Line : 286 FAYVILLE RD
Second Line :
City : GALWAY
State : NY
Zip : 12074-3426
Country : US
Telephone Number : 518-883-3283
Fax Number : 518-347-5330
Provider Business Practice Location Address
First Line : 600 MCCLELLAN ST
Second Line : ST CLAIRES HOSPITAL WOUND CARE CENTER
City : SCHENECTADY
State : NY
Zip : 12304-1009
Country : US
Telephone Number : 518-347-5442
Fax Number : 518-347-5330
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2005
Last Update Date : 10/03/2007

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