DE LUCIA ADVANCE PRACTICE NPI 1194061879

NPI Information

NPI: 1194061879
Provider Name: DE LUCIA ADVANCE PRACTICE
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Organization

Specialization: Acute Care

CLIA Number: 31D2052697

Address:
7617 KENNEDY BLVD
NORTH BERGEN, NJ
ZIP 07047
Phone: (201) 854-1500
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DE LUCIA ADVANCE PRACTICE is an acute care nurse practitioner in North Bergen, NJ. DE LUCIA ADVANCE PRACTICE NPI is 1194061879. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7617 KENNEDY BLVD
NORTH BERGEN, NJ
ZIP 07047-024
Phone: (201) 854-1500
Fax: (201) 854-1505

The provider's authorized official is Lauren Michele De Lucia .
The authorized official title is Ceo/owner and has the following contact phone number (201) 854-1500.

The CLIA number assigned to this NPI record is 31D2052697 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/27/2012 and was last updated on 12/10/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	26NJ00060000	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	Q23636	MEDICARE UPIN	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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