Lucero, Agnes M

Lucero, Agnes M is an individual health care provider with primary practice located at Three Barker Avenue 4Th Floor Park Avenue Medical Associates Pc, White Plains NY 10601. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Lucero, Agnes M can be contacted via phone (914) 949-1199.

Contact Information

Primary practice address
Three Barker Avenue 4Th Floor Park Avenue Medical Associates Pc White Plains NY 10601
Phone: (914) 949-1199
Fax: (914) 949-1245
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X F302218 New York

Profile Details

NPI number 1114952785
LBN Legal business name Lucero, Agnes M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114952785 NPPES
New York MEDICAID 02664515

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