Edwin Gituayan Luceno, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

013202-02 Issued in NY

Practice address

2444 Beaumont Ave
Bronx, NY 10458-6548

Phone

(347) 679-7078

NPI assigned

May 12, 2023

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1683849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1235829144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2444 BEAUMONT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104586548",
            "telephone_number": "347-679-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2444 BEAUMONT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104586548",
            "telephone_number": "347-679-7078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCENO",
        "first_name": "EDWIN",
        "middle_name": "GITUAYAN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-12",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "013202-02",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tasheema Lucas, LMSW
• Tiffany Marie Lucas, RPH
• Yahaira Lucca
• Gabriell A Lucchese, M.S., CF-SLP, TSSLD
• Francisco Jose Lucena Bezerra, MD
• Ana Sofia Lucero, MS
• Denise Lucero
• Jasmin Lucero, MSED
• Michelle Enid Lucero, M.S.
• Shanae Jonell Luces

• Physical Therapy Assistant in Bronx, NY
• Providers in Bronx, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.