Individual
MS. MARY EDITH LUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
235 N PEARL ST, BROCKTON, MA 02301-1794
(508) 427-3000
Mailing address
960 MASSACHUSETTS AVE STE 2, BOSTON, MA 02118-2690
(617) 414-5405
(617) 789-3015
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
NA-00184
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0157682
—
OH
01
—
P00949833
MEDICARE RAILROAD
OH
Enumeration date
12/20/2005
Last updated
03/06/2025
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