MEDICARE: PAIGE LUCARELLI NP

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	363L00000X	Nurse Practitioner	LG-0000847	DE

General Provider Information

NPI Number	:	1942681044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAIGE LUCARELLI NP

Provider Business Mailing Address
First Line	:	200 HYGEIA DR
Second Line	:	SUITE 2300
City	:	NEWARK
State	:	DE
Zip	:	19713-2049
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	190 SALEM CHURCH RD
Second Line	:
City	:	NEWARK
State	:	DE
Zip	:	19713-2938
Country	:	US
Telephone Number	:	302-454-5421
Fax Number	:	302-368-1421

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

Provider Enumeration Date	:	06/15/2015
Last Update Date	:	06/15/2015

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