Provider Demographics
NPI:1790532968
Name:DE LUCAS, FRANCIS (PTA)
Entity type:Individual
Prefix:
First Name:FRANCIS
Middle Name:
Last Name:DE LUCAS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:FRANCIS
Other - Middle Name:ESTHER
Other - Last Name:MARTINEZ RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 638
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-0638
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2003 CONEY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2328
Practice Address - Country:US
Practice Address - Phone:347-394-1600
Practice Address - Fax:347-394-5059
Is Sole Proprietor?:No
Enumeration Date:2024-05-04
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant