Healthcare Provider Details

I. General information

NPI: 1497432660
Provider Name (Legal Business Name): LUCENTE NP IN FAMILY HEALTH WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2023
Last Update Date: 06/29/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 84TH ST
BROOKLYN NY
11214-2825
US

IV. Provider business mailing address

88 STECHER ST
STATEN ISLAND NY
10312-4412
US

V. Phone/Fax

Practice location:
  • Phone: 718-885-8484
  • Fax:
Mailing address:
  • Phone: 718-213-9180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN LUCENTE
Title or Position: CEO
Credential: FNP
Phone: 718-213-9180