Individual
JESSE LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 WOODSIDE AVE, NEWARK, NJ 07104-3243
(623) 296-2034
Mailing address
401 WOODSIDE AVE, NEWARK, NJ 07104-3243
(623) 296-2034
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
NJ
Other
Enumeration date
02/27/2022
Last updated
02/27/2022
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