Provider Demographics
NPI:1033358916
Name:LUCENTE, JOHN (FNP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:LUCENTE
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 84TH STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214
Mailing Address - Country:US
Mailing Address - Phone:718-232-3666
Mailing Address - Fax:
Practice Address - Street 1:1740 84TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-2825
Practice Address - Country:US
Practice Address - Phone:718-232-3666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-17
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333646-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00743080OtherMEDICARE RAILROAD
NYF333646-1OtherNURSING PRACTITIONER LIC.
NY03093010Medicaid
NYA400008197Medicare PIN