Individual
BRAXTON LUCERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 CLARA MAASS DR, BELLEVILLE, NJ 07109-3550
(973) 450-2000
Mailing address
30 ARDSLEY CT, EAST BRUNSWICK, NJ 08816-3673
(801) 458-9687
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00534400
NJ
Other
Enumeration date
05/04/2019
Last updated
08/20/2019
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