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General NPI Number Information
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NPI Number | 1225188543
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Entity Type | Individual
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Provider Name | GRACIANO LUCERO ZARA MD
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Gender | Male
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 07/13/2022
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Provider Practice Location Address
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Address Line | 137 LIVINGSTON AVE
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-2497
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Country | US
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Telephone | 732-390-8161
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Fax | 732-390-6110
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Provider Business Mailing Address
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Address Line | 137 LIVINGSTON AVENUE
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901
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Country | US
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Telephone | 732-545-0051
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA06494900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA06494900
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License Number State | NJ
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