Individual
LISA LUCCHESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
40 KENSINGTON AVENUE, SELDEN, NY 11784
(631) 942-6096
Mailing address
215 TERRY ROAD, UNIT 14A, SMITHTOWN, NY 11787
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
475990
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01637883
—
NY
Enumeration date
05/10/2018
Last updated
05/10/2018
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