Provider Demographics
NPI:1972601862
Name:BARONE, LUCIANO V (MD)
Entity type:Individual
Prefix:
First Name:LUCIANO
Middle Name:V
Last Name:BARONE
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 1:10 RONALD REAGAN BLVD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-4104
Mailing Address - Country:US
Mailing Address - Phone:845-986-2058
Mailing Address - Fax:845-986-7669
Practice Address - Street 1:10 RONALD REAGAN BLVD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-4104
Practice Address - Country:US
Practice Address - Phone:845-986-2058
Practice Address - Fax:845-986-7669
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142359-1208000000X
NJ25MA0664880208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1043307Medicaid
NY00612006Medicaid
NJ1043307Medicaid
NYA400008517Medicare PIN
NY00612006Medicaid