Individual
DR. CHARLES JOSEPH DELUCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2429 GRAND AVE, BALDWIN, NY 11510-3219
(516) 223-0528
(516) 223-0730
Mailing address
2246 PARK PL, NORTH MERRICK, NY 11566-2812
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV005434-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A400042587
MEDICARE GROUP MEMBER PTAN
NY
Enumeration date
04/02/2007
Last updated
04/10/2016
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