Provider Demographics
NPI:1164137618
Name:LUCAS, SYDNEY PATRICIA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SYDNEY
Middle Name:PATRICIA
Last Name:LUCAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MIDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1811
Mailing Address - Country:US
Mailing Address - Phone:973-590-6685
Mailing Address - Fax:
Practice Address - Street 1:197 RIDGEDALE AVE STE 300
Practice Address - Street 2:
Practice Address - City:CEDAR KNOLLS
Practice Address - State:NJ
Practice Address - Zip Code:07927-2111
Practice Address - Country:US
Practice Address - Phone:973-538-2234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical