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Individual

MRS. GINA LUCARELLI WILBER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
27 RANDOLPH RD, HOWELL, NJ 07731-8611
(866) 415-8251
Mailing address
80 CLUB DR, BERLIN, CT 06037-1132
(860) 221-5556

Taxonomy

Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
005264
CT
363A00000X
Physician Assistant
5264
CT
363AM0700X
Medical Physician Assistant
5264
CT

Other

Enumeration date
06/04/2021
Last updated
10/31/2022
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