Provider Demographics
NPI:1134212798
Name:LUCAS, CYNTHIA M (PA)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:M
Last Name:LUCAS
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:280 CHESTNUT STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:2 MEDICAL CENTER DRIVE
Practice Address - Street 2:STE 308
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1270
Practice Address - Country:US
Practice Address - Phone:413-794-7020
Practice Address - Fax:413-794-2670
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2018-02-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA2141363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AP2722Medicare PIN