Organization
KIMBERLY ANN LUCEY M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY ANN LUCEY M.D. (PRESIDENT)
(860) 749-6485
Entity
Organization
Contact information
Practice address
1699 KING ST STE 102, ENFIELD, CT 06082-6052
(860) 749-6485
(860) 749-1562
Mailing address
1699 KING ST STE 102, ENFIELD, CT 06082-6052
(860) 749-6485
(860) 749-1562
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
032769CT
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C02837
MEDICARE GROUP NUMBER
CT
Enumeration date
07/20/2007
Last updated
07/07/2020
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