Individual
DR. LUCA DI MATTEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
538 HOPMEADOW ST, SIMSBURY, CT 06070-2415
(860) 651-8557
Mailing address
538 HOPMEADOW STREET, SIMSBURY, CT 06070-2415
(860) 651-8557
(860) 651-9558
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
000596
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004123139
—
CT
01
—
030000596CT01
ANTHEM BLUE SHIELD
CT
Enumeration date
07/04/2006
Last updated
01/28/2010
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