Individual
KENNETH G LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
179 RIVER ST, ONEONTA, NY 13820-2239
(607) 433-3484
(607) 432-5790
Mailing address
33 LEWIS RD, 2ND FL, BINGHAMTON, NY 13905
(607) 729-8156
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
188726
NY
2080P0207X
Pediatric Hematology & Oncology Physician
188726
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012617180002
—
PA
Enumeration date
05/27/2006
Last updated
05/03/2019
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