Provider Demographics
NPI:1659818490
Name:LUCE, ROBERT GEORGE JR
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:GEORGE
Last Name:LUCE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 FISHER ST
Mailing Address - Street 2:
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081-3908
Mailing Address - Country:US
Mailing Address - Phone:508-668-3431
Mailing Address - Fax:508-668-7863
Practice Address - Street 1:201 FISHER ST
Practice Address - Street 2:
Practice Address - City:WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02081-3908
Practice Address - Country:US
Practice Address - Phone:508-668-3431
Practice Address - Fax:508-668-7863
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals