Provider Demographics
NPI:1124197355
Name:NACEY, LUCY M (DC)
Entity Type:Individual
Prefix:DR
First Name:LUCY
Middle Name:M
Last Name:NACEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 487
Mailing Address - Street 2:
Mailing Address - City:MARS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-0487
Mailing Address - Country:US
Mailing Address - Phone:724-625-3974
Mailing Address - Fax:724-625-3973
Practice Address - Street 1:441 MARS-VALENCIA ROAD
Practice Address - Street 2:
Practice Address - City:MARS
Practice Address - State:PA
Practice Address - Zip Code:16046-0487
Practice Address - Country:US
Practice Address - Phone:724-625-3974
Practice Address - Fax:724-625-3973
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003973L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1589723OtherHIGHMARK GROUP PROVIDER
PA520513OtherHIGHMARK INDIVIDUAL PROVI
PAP00320447OtherRAILROAD PROVIDER NUMBER
PA520513Medicare ID - Type Unspecified
PAU11538Medicare UPIN