Provider Demographics
NPI:1619122132
Name:LUCIA, KARA MARIE
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:MARIE
Last Name:LUCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 RANDOLPH PL
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-1261
Mailing Address - Country:US
Mailing Address - Phone:718-208-5412
Mailing Address - Fax:
Practice Address - Street 1:3225 RANDOLPH PL
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-1261
Practice Address - Country:US
Practice Address - Phone:718-208-5412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014778-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist