MEDICARE: DR. ANTHONY JOSEPH LUCATORTO D.O.

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	207Q00000X	Family Medicine Physician	25MB06095000	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P376680	OTHER	NJ	OXFORD HEALTH PLAN ID
2	0811246000	OTHER	NJ	AMERIHEALTH HMO
3	200563432	OTHER	NJ	BCBS FEDERAL EMPLOYEE
4	000786118	OTHER	NJ	HIGHMARK BLUE SHIELD ID
5	200563432	OTHER	NJ	UNITED HEALTHCARE ID
6	200563432	OTHER	NJ	QUALCARE PPO HMO ID
7	2355303001	OTHER	NJ	AMERIHEALTH HMO

General Provider Information

NPI Number	:	1760443030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY JOSEPH LUCATORTO D.O.

Provider Business Mailing Address
First Line	:	28 BOWLING GREEN PARKWAY
Second Line	:	SUITE LL3
City	:	LAKE HOPATCONG
State	:	NJ
Zip	:	07849-2445
Country	:	US
Telephone Number	:	973-663-8899
Fax Number	:	973-663-9511

Provider Business Practice Location Address
First Line	:	28 BOWLING GREEN PARKWAY
Second Line	:	SUITE LL3
City	:	LAKE HOPATCONG
State	:	NJ
Zip	:	07849-2445
Country	:	US
Telephone Number	:	973-214-8679
Fax Number	:	973-663-9511

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

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	09/23/2024

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