Provider Demographics
NPI:1154294262
Name:BOSCOLO BIELO, LUCA (MD)
Entity type:Individual
Prefix:DR
First Name:LUCA
Middle Name:
Last Name:BOSCOLO BIELO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 E 77TH ST APT 2D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-2199
Mailing Address - Country:US
Mailing Address - Phone:646-234-6585
Mailing Address - Fax:
Practice Address - Street 1:250 E 77TH ST APT 2D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-2199
Practice Address - Country:US
Practice Address - Phone:646-234-6585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP134657207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology