NPI Index

MRS. SHANNON DELUCA, P.T.

Physical Therapist

Active Individual
NPI: 1053630418

Practice Address

1010 ROUTE 112
SUITE 200
Port Jefferson Station, NY 11776

Phone: (631) 476-4880

Specialties

Specialty Code Primary License
Specialist 174400000X No 028273 (NY)
Physical Therapist 225100000X Yes 028273 (NY)

Frequently Asked Questions

NPI 1053630418 is the National Provider Identifier for MRS. SHANNON DELUCA, P.T., a Physical Therapist provider located in Port Jefferson Station, NY. This NPI was enumerated on May 25, 2010.
MRS. SHANNON DELUCA, P.T. practices at 1010 ROUTE 112, SUITE 200, Port Jefferson Station, NY 11776.

Quick Facts

NPI
1053630418
Type
Individual
Enumerated
May 25, 2010
Last Updated
Jun 7, 2016

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