MEDICARE: MS. SONDRA G. LUCENTE M.S.

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	235Z00000X	Speech-Language Pathologist	015107-1	NY
2	235Z00000X	Speech-Language Pathologist	41YS00528500	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3961769	OTHER	NY	AETNA HMO

General Provider Information

NPI Number	:	1154543437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SONDRA G. LUCENTE M.S.

Provider Business Mailing Address
First Line	:	22 HELEN WAY
Second Line	:
City	:	BERKELEY HEIGHTS
State	:	NJ
Zip	:	07922-1542
Country	:	US
Telephone Number	:	215-837-5090
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 HELEN WAY
Second Line	:
City	:	BERKELEY HEIGHTS
State	:	NJ
Zip	:	07922-1542
Country	:	US
Telephone Number	:	215-837-5090
Fax Number	:

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

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	06/29/2011

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Directions to “ MS. SONDRA G. LUCENTE M.S.” Practice Location

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