Provider Demographics
NPI:1568494383
Name:LEN, LUCILLE T (MD)
Entity Type:Individual
Prefix:DR
First Name:LUCILLE
Middle Name:T
Last Name:LEN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:3322 ROUTE 22 STE 1204
Practice Address - Street 2:
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-4407
Practice Address - Country:US
Practice Address - Phone:908-378-7227
Practice Address - Fax:908-252-0127
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2020-05-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA04075700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC58287Medicare UPIN
NJ461819Medicare ID - Type Unspecified