Healthcare Provider Details

I. General information

NPI: 1134144975
Provider Name (Legal Business Name): DIANE ELIZABETH LUCENTE MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 CAMBRIDGE ST CPZN, RM 5820
BOSTON MA
02114-2790
US

IV. Provider business mailing address

82 EXCHANGE ST
WALTHAM MA
02451-4554
US

V. Phone/Fax

Practice location:
  • Phone: 617-643-3199
  • Fax: 617-726-5735
Mailing address:
  • Phone: 781-893-2449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: