Individual
TANYA P. LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 SOUTH ST, SOUTHBRIDGE, MA 01550-4051
(508) 764-8012
Mailing address
100 SOUTH ST, SOUTHBRIDGE, MA 01550-4051
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
154202
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110061755A
—
MA
Enumeration date
11/02/2005
Last updated
04/24/2025
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