Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0102X | Surgical Critical Care | 301366 | NY |
Y | 2086S0127X | Trauma Surgeon | 301366 | NY |
NPI | 1235559915 |
---|---|
Provider Name | Dr. Michael Daniel Luca |
First Address | Syracuse, NY 13210-2306 |
Second Address | Syracuse, NY 13210-2306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2014 |
Last Update Date | 20/07/2020 |