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Individual

MICHAEL A LUCCI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2566 HAYMAKER RD STE 203, MONROEVILLE, PA 15146-3554
(412) 858-7088
(412) 858-7016
Mailing address
2566 HAYMAKER RD STE 203, MONROEVILLE, PA 15146-3554
(412) 858-7088
(412) 858-7016

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA052358
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103192461
PA
01
11589099
CAQH
Enumeration date
02/28/2006
Last updated
10/06/2020
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