Provider Demographics
NPI:1952015976
Name:LUCAS, GERALDINE FRANCES (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:GERALDINE
Middle Name:FRANCES
Last Name:LUCAS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 ASTER CT
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-5934
Mailing Address - Country:US
Mailing Address - Phone:718-769-0628
Mailing Address - Fax:
Practice Address - Street 1:17 ASTER CT
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5934
Practice Address - Country:US
Practice Address - Phone:718-769-0628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236284163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse