Provider Demographics
NPI:1437197324
Name:LUCACEL, CARLA ADRIANA (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:ADRIANA
Last Name:LUCACEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4224 GREENPOINT AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-3004
Mailing Address - Country:US
Mailing Address - Phone:718-482-6814
Mailing Address - Fax:718-482-6817
Practice Address - Street 1:4224 GREENPOINT AVE
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11104-3004
Practice Address - Country:US
Practice Address - Phone:718-482-6814
Practice Address - Fax:718-482-6817
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236859208000000X
NJ25MA08013100208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYLC6853OtherATLANTIS
NY00042360914OtherHEALTHPLUS
NY009248-CLOtherMETROPLUS
NY217859POtherHIP
NY2571196OtherUNITEDHEALTHCARE
NY23685901OtherNEIGHBORHOOD
NYP3663889OtherOXFORD
NY000000105147OtherGHI HMO
NY0102793-01OtherAMERICHOICE
NY1000037513OtherAFFINITY
NY2605060OtherGHI PPO
NY316422OtherWELLCARE
NY7043716OtherAETNA PPO
NY203253540LU01OtherCAREPLUS
NY236859NYOther1199 NBF
NY3949387OtherCIGNA
NY5653922OtherFIRSTHEALTH
NY236859A29OtherHEALTHFIRST
NY2482UOtherEMPIRE BC/BS
NY02688700Medicaid