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Provider Information for 1447239413


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Dr. DANIELLE ELIZABETH LUCIANO M.D.


Sex: Female

NPI: 1447239413
Last Updated: 2022-11-07
Certification Date:

Details

NameValue
NPI1447239413
Enumeration Date2006-01-10
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 263 FARMINGTON AVE
PROVIDER ENROLLMENT
FARMINGTON, CT 06030-2212
United States

Phone: 860-679-2792 | Fax:860-679-1494
 
Primary Practice Address 1115 WEST ST
2ND FLOOR
SOUTHINGTON, CT 06489-6025
United States

Phone: 860-276-6043 | Fax:860-276-6059
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Direct Messaging Address
dluciano10409@direct.med.uchc.edu
Uconn Medical Group
Farmington, CT 06030-0001
United States
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDCT001434084
Other (non-Medicare)CT010043408 CT 01Anthem BC & BS NB Office
Other (non-Medicare)010043408 CT 02Anthem BC & BS Htfd. Off
Other (non-Medicare)CT20-1997579Community Health Network
Other (non-Medicare)CT20-1997579Private Health Care Syste
Other (non-Medicare)CT20-1997579United Health Care
Other (non-Medicare)CT294113WellCare Preferred One
Other (non-Medicare)CT2V7377Healthnet
Other (non-Medicare)CO7253733Aetna
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 207VG0400X - Obstetrics & Gynecology - GynecologyCT043408