Individual
MS. TANYA LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
4 SKYLINE DR, SUITE 7, HAWTHORNE, NY 10532-2147
(914) 467-7343
(914) 418-1042
Mailing address
1515 SOUTHERN BLVD, BRONX, NY 10460
(718) 860-8595
(718) 991-3824
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
488352-1
NY
363LW0102X
Women's Health Nurse Practitioner
Primary
F420900-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3452884
—
NY
Enumeration date
06/23/2009
Last updated
09/06/2024
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