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NPI Code Detail

MEDICARE: DR. LUCIAN J INTROCASO MD

MEDICARE:  DR. LUCIAN J INTROCASO  MD
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
1207R00000XInternal Medicine Physician25MA04506200NJ
22083P0500XPreventive Medicine/Occupational Environmental Medicine Physician25MA04506200NJ

General Provider Information

NPI Number : 1386795680
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LUCIAN J INTROCASO MD
Provider Business Mailing Address
First Line : 2 CRESTMONT LN
Second Line :
City : COLLINGSWOOD
State : NJ
Zip : 08108-1487
Country : US
Telephone Number : 856-662-0660
Fax Number :
Provider Business Practice Location Address
First Line : 9370 N CRESCENT BLVD STE 200
Second Line :
City : PENNSAUKEN
State : NJ
Zip : 08110-1375
Country : US
Telephone Number : 856-662-0660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2007
Last Update Date : 09/11/2025

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Directions to “ DR. LUCIAN J INTROCASO MD” Practice Location

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