Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 44583 | AZ |
Y | 2080P0204X | Pediatric Emergency Doctor | 44583 | AZ |
NPI | 1215193503 |
---|---|
Provider Name | Dr. William N Luciano |
First Address | Phoenix, AZ 85018-2327 |
Second Address | Phoenix, AZ 85016-7710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2008 |
Last Update Date | 17/01/2018 |