# MICHAEL W. LUCARELLI D.O.,INC.

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

## Provider details

- **NPI number:** 1699909747
- **Authorized official:** DR. MICHAEL WILLIAM LUCARELLI D.O. (PHYSICIAN/PRESIDENT)
- **Authorized official phone:** (401) 471-6850

## Contact information

- **Practice address:** 3461 S COUNTY TRL, SUITE 201, EAST GREENWICH, RI 02818-1463
- **Practice address phone:** (401) 471-6850
- **Practice address fax:** (401) 471-6855
- **Mailing address:** 3461 S COUNTY TRL, SUITE 201, EAST GREENWICH, RI 02818-1463
- **Mailing address phone:** (401) 471-6850
- **Mailing address fax:** (401) 471-6855

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | DO00491 | RI | Yes |

## Other

- **Enumeration date:** 05/04/2009
- **Last updated:** 05/04/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 089002947 | MEDICARE | — |