Provider Demographics
NPI:1336697036
Name:WEST, LUCAS H (AUD)
Entity Type:Individual
Prefix:DR
First Name:LUCAS
Middle Name:H
Last Name:WEST
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1953 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-2820
Mailing Address - Country:US
Mailing Address - Phone:516-864-6289
Mailing Address - Fax:631-499-3062
Practice Address - Street 1:233 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-4924
Practice Address - Country:US
Practice Address - Phone:855-423-3700
Practice Address - Fax:631-499-3062
Is Sole Proprietor?:No
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY57002689231H00000X
NY14000048378237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist