Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 161082 | NY |
Y | 207QA0505X | Family Doctor - Adult Medicine | 161082 | NY |
NPI | 1225175615 |
---|---|
Provider Name | Dr. Richard M Lucchesi |
First Address | Providence, RI 02908 |
Second Address | Hyannis, MA 02601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 10/10/2017 |