Provider Demographics
NPI:1982804498
Name:LUCCI, DONNA
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:LUCCI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 ALDERSGATE WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH READING
Mailing Address - State:MA
Mailing Address - Zip Code:01864-3231
Mailing Address - Country:US
Mailing Address - Phone:978-844-1882
Mailing Address - Fax:
Practice Address - Street 1:9 ALDERSGATE WAY
Practice Address - Street 2:
Practice Address - City:NORTH READING
Practice Address - State:MA
Practice Address - Zip Code:01864-3231
Practice Address - Country:US
Practice Address - Phone:978-844-1882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1530225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9786586941Medicare NSC