Individual
KIM LUCIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN, C
Contact information
Practice address
249 S MAIN ST STE 2, BARNEGAT, NJ 08005-2369
(609) 607-1010
Mailing address
401 ROUTE 73 N STE 320, MARLTON, NJ 08053-3426
(609) 607-1010
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
26NN07311100
NJ
363LP0200X
Pediatric Nurse Practitioner
Primary
26NN07311100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6769004
—
NJ
Enumeration date
06/10/2005
Last updated
08/23/2022
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