MEDICARE: BRIANA ALICIA LUCAS RN, LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	335196	NY
2	163W00000X	Registered Nurse	987521	NY

General Provider Information

NPI Number	:	1528624335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANA ALICIA LUCAS RN, LPN

Provider Business Mailing Address
First Line	:	8 MAYFAIR CT
Second Line	:
City	:	CHEEKTOWAGA
State	:	NY
Zip	:	14225-2137
Country	:	US
Telephone Number	:	716-531-0628
Fax Number	:

Provider Business Practice Location Address
First Line	:	8 MAYFAIR CT
Second Line	:
City	:	CHEEKTOWAGA
State	:	NY
Zip	:	14225-2137
Country	:	US
Telephone Number	:	716-531-0628
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2019
Last Update Date	:	12/16/2025

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