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Organization
KELLY LUCAS DPM PC
Active
Organization
KELLY LUCAS DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY M LUCAS DPM (PRESIDENT)
(516) 352-4454
Entity
Organization
Contact information
Practice address
925 HEMPSTEAD TPKE STE 110, FRANKLIN SQUARE, NY 11010-3636
(516) 352-4454
Mailing address
73 E SHORE RD, HALESITE, NY 11743-1127
(516) 352-4454
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
12/10/2019
Last updated
12/10/2019
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