Individual
LYDIA ANN PATRICK-DELUCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN RN APN-C
Contact information
Practice address
88 PORTER PL, MONTCLAIR, NJ 07042-2036
(973) 865-4632
Mailing address
88 PORTER PL, MONTCLAIR, NJ 07042-2036
(973) 865-4632
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
26NJ00228000
NJ
363LP2300X
Primary Care Nurse Practitioner
Primary
26NJ00228000
NJ
Other
Enumeration date
08/13/2009
Last updated
08/13/2009
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