1497037279 NPI number — ARTHUR DELUCA MD PEDIATRIC PULMONOLOGY OF LONG ISLAND

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497037279 NPI number — ARTHUR DELUCA MD PEDIATRIC PULMONOLOGY OF LONG ISLAND

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARTHUR DELUCA MD PEDIATRIC PULMONOLOGY OF LONG ISLAND
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497037279
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/16/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3016 37TH ST
Provider Second Line Business Mailing Address:
THIRD FLOOR
Provider Business Mailing Address City Name:
ASTORIA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11103-3809
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-288-1474
Provider Business Mailing Address Fax Number:
718-278-2430

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3016 37TH ST
Provider Second Line Business Practice Location Address:
THIRD FLOOR
Provider Business Practice Location Address City Name:
ASTORIA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11103-3809
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-288-1474
Provider Business Practice Location Address Fax Number:
718-278-2430
Provider Enumeration Date:
09/16/2011

Additional Information

Authorized Official

Authorized Official Last Name:
DELUCA
Authorized Official First Name:
ARTHUR
Authorized Official Middle Name:
JOHN
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
718-288-1474

Provider Taxonomy Codes

  • Taxonomy code: 2080P0214X , with the licence number:  191559 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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