Luchetti, Mary Ellen Joan
Luchetti, Mary Ellen Joan is an sole proprietor health care provider with primary practice located at 1021 Medical Arts Ave Ne , Albuquerque NM 87102-2708. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Luchetti, Mary Ellen Joan can be contacted via phone (505) 272-6222.Contact Information
Primary practice address
1021 Medical Arts Ave Ne
Albuquerque NM 87102-2708
Phone: (505) 272-6222
Fax: (505) 272-6228
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 28963 | Arizona |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 044009 | Georgia |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | MD2006-0021 | New Mexico |
Profile Details
| NPI number | 1679565964 |
|---|---|
| LBN Legal business name | Luchetti, Mary Ellen Joan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 22nd, 2005 |
| Last updated | Apr 26th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679565964 | NPPES |
| Georgia | MEDICAID | 003137516 |
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