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NPI Code Detail

MEDICARE: MRS. TIFFANY MARIE LUCAS RPH

MEDICARE: MRS. TIFFANY MARIE LUCAS RPH
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
1183500000XPharmacist048374NY

General Provider Information

NPI Number : 1588654362
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TIFFANY MARIE LUCAS RPH
Provider Business Mailing Address
First Line : 212 WEST ST
Second Line :
City : MAMARONECK
State : NY
Zip : 10543-3138
Country : US
Telephone Number : 917-716-7378
Fax Number :
Provider Business Practice Location Address
First Line : 2941 WESTCHESTER AVE
Second Line :
City : BRONX
State : NY
Zip : 10461-4534
Country : US
Telephone Number : 718-823-1085
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2005
Last Update Date : 04/06/2020

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Directions to “ MRS. TIFFANY MARIE LUCAS RPH” Practice Location

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