MEDICARE: DR. LUCRECIA ALBURQUERQUE 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
1	174400000X	Specialist	MA34005	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922077817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUCRECIA ALBURQUERQUE MD

Provider Business Mailing Address
First Line	:	412 PARK AVE
Second Line	:
City	:	PATERSON
State	:	NJ
Zip	:	07504-1930
Country	:	US
Telephone Number	:	973-684-1302
Fax Number	:	973-684-0144

Provider Business Practice Location Address
First Line	:	412 PARK AVE
Second Line	:
City	:	PATERSON
State	:	NJ
Zip	:	07504-1930
Country	:	US
Telephone Number	:	973-684-1302
Fax Number	:	973-684-0144

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	07/08/2007

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