Basic Information
Provider Information
NPI: 1336117860
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LLUGANY
FirstName: OSCAR
MiddleName: J.
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3040 AMSDELL RD
Address2:  
City: HAMBURG
State: NY
PostalCode: 140755835
CountryCode: US
TelephoneNumber: 7166499000
FaxNumber: 7166499005
Practice Location
Address1: 565 ABBOTT RD
Address2:  
City: BUFFALO
State: NY
PostalCode: 142202039
CountryCode: US
TelephoneNumber: 7168282399
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/10/2006
LastUpdateDate: 09/16/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085B0100X115761NYY Allopathic & Osteopathic PhysiciansRadiologyBody Imaging
2085R0202X115761NYN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
0067364305NY MEDICAID
04042600021201NYFIDELIS CARE OF NEW YORKOTHER
146160FF01NYPREFERRED CAREOTHER
30008052401NYRR MEDICAREOTHER
160920601NYINDEPENDENT HEALTHOTHER
0002636640601NYUNIVERA HEALTHCAREOTHER
00050761900601NYBCBSOTHER


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