Provider Demographics
NPI:1639276207
Name:LUCARELLI, JAMES E (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:LUCARELLI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 GRAPE ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-2143
Mailing Address - Country:US
Mailing Address - Phone:508-991-4100
Mailing Address - Fax:508-994-2103
Practice Address - Street 1:92 GRAPE ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-2143
Practice Address - Country:US
Practice Address - Phone:508-991-4100
Practice Address - Fax:508-994-2103
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1979213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0358061Medicaid
MA0358061Medicaid
MAY70969Medicare ID - Type Unspecified