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Individual

DIANA DELUCA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
55 JOHANNA LN, STATEN ISLAND, NY 10309-3632
(718) 966-7784
Mailing address
55 JOHANNA LN, STATEN ISLAND, NY 10309-3632

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary

Other

Enumeration date
05/09/2015
Last updated
05/09/2015
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