Basic Information
| Provider Information | |||||||||
| NPI: | 1942208392 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LUCHETTI | ||||||||
| FirstName: | WAYNE | ||||||||
| MiddleName: | THOMAS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 783311 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191783311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4848844500 | ||||||||
| FaxNumber: | 4848840699 | ||||||||
| Practice Location | |||||||||
| Address1: | 2775 SCHOENERSVILLE RD | ||||||||
| Address2: | |||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180177307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108618080 | ||||||||
| FaxNumber: | 6108070366 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2005 | ||||||||
| LastUpdateDate: | 02/16/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XX0005X | MD057357L | PA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine | 207X00000X | MD057357L | PA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 01210001 | 01 | KEYSTONE HEALTH CENTRAL | OTHER | 0870150000 | 01 | INDEPENDENCE BLUE CROSS | OTHER | 1879164 | 01 | UNITED HEALTHCARE | OTHER | 810225603 | 01 | PRIVATE HEALTHCARE SYSTEM | OTHER | 0018481920001 | 05 | PA | MEDICAID | 7613315 | 01 | CIGNA HEALTHCARE | OTHER | 328817 | 01 | HEALTH AMERICA/HEALTH ASS | OTHER | 01210001 | 01 | CAPITAL BLUE CROSS | OTHER | 0870150000 | 01 | AMERIHEALTH | OTHER | 0870150000 | 01 | KEYSTONE HEALTH EAST | OTHER | 2581586 | 01 | AETNA PPO | OTHER | 924697 | 01 | FIRST PRIORITY LIFE INS. | OTHER | P2531935 | 01 | OXFORD HEALTH PLANS | OTHER | 200040875 | 01 | RAILROAD MEDICARE | OTHER | 77834 | 01 | GEISINGER HEALTH PLAN | OTHER | 819554 | 01 | FIRST PRIORITY HEALTH | OTHER | 924697 | 01 | HIGHMARK BLUE SHIELD | OTHER |