# LUCIANO J. BISPO, MD, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407860760
- **Authorized official:** LUCIANO J BISPO M.D. (PRESIDENT)
- **Authorized official phone:** (856) 205-0606

## Contact information

- **Practice address:** 2950 COLLEGE DR, STE 2F, VINELAND, NJ 08360-6933
- **Practice address phone:** (856) 205-0606
- **Practice address fax:** (856) 205-0044
- **Mailing address:** 175 W COHAWKIN RD STE C, CLARKSBORO, NJ 08020-1145
- **Mailing address phone:** (856) 423-7700
- **Mailing address fax:** (856) 423-0823

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | MA07269600 | NJ | Yes |

## Other

- **Enumeration date:** 07/29/2006
- **Last updated:** 06/12/2013