Petitti, Luciana Marie
Petitti, Luciana Marie is an individual health care provider with primary practice located at 3701 Franklin St , Michigan City IN 46360-7310. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Petitti, Luciana Marie can be contacted via phone (219) 872-8844.Contact Information
Primary practice address
3701 Franklin St
Michigan City IN 46360-7310
Phone: (219) 872-8844
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 046.011192 | Illinois |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 18004201A | Indiana |
Profile Details
| NPI number | 1750867206 |
|---|---|
| LBN Legal business name | Petitti, Luciana Marie |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 18th, 2018 |
| Last updated | May 2nd, 2024 - about 7 months 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 | 1750867206 | NPPES |
| Indiana | MEDICAID | 300032397 |
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