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General NPI Number Information
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NPI Number | 1164137618
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Entity Type | Individual
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Provider Name | SYDNEY PATRICIA LUCAS PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/19/2023
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Last Update Date | 01/19/2023
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Provider Practice Location Address
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Address Line | 197 RIDGEDALE AVE STE 300
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City | CEDAR KNOLLS
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State | NJ
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Zip | 07927-2111
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Country | US
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Telephone | 973-538-2234
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Fax |
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Provider Business Mailing Address
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Address Line | 2 MIDWOOD DR
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City | FLORHAM PARK
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State | NJ
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Zip | 07932-1811
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Country | US
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Telephone | 973-590-6685
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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