Individual
DR. IRENE DIANE LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
62 N MOUNTAIN BLVD, MOUNTAIN TOP, PA 18707-1117
(570) 474-6562
(570) 474-0796
Mailing address
62 N MOUNTAIN BLVD, MOUNTAIN TOP, PA 18707-1117
(570) 474-6562
(570) 474-0796
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD0339709
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010752110001
—
PA
Enumeration date
08/22/2005
Last updated
07/12/2010
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