Individual
LUCIANO J BISPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2950 COLLEGE DR, STE 2F, VINELAND, NJ 08360-6933
(856) 205-0606
(856) 205-0044
Mailing address
227 LAUREL RD, STE 300, VOORHEES, NJ 08043-8303
(856) 669-6050
(856) 651-0794
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
25MA07269600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8949107
—
NJ
Enumeration date
12/20/2005
Last updated
11/15/2011
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