Provider Demographics
NPI:1215296959
Name:LUCIANO, DAVID (LPN)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:LUCIANO
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:674 HAWKINS RD E
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-1810
Mailing Address - Country:US
Mailing Address - Phone:631-741-5646
Mailing Address - Fax:
Practice Address - Street 1:674 HAWKINS RD E
Practice Address - Street 2:
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-1810
Practice Address - Country:US
Practice Address - Phone:631-741-5646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309898164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse