Provider Demographics
NPI:1790540391
Name:LUCID, LAURA (MS)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:LUCID
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2884 SADDLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-2310
Mailing Address - Country:US
Mailing Address - Phone:516-647-3628
Mailing Address - Fax:
Practice Address - Street 1:2884 SADDLE RIDGE DR
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-2310
Practice Address - Country:US
Practice Address - Phone:516-647-3628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist