Braxton Lucero
Physician Assistant in Belleville, NJ. Individual provider (NPI-1).
NPI number1629633797
StatusActive
Last updated in NPPESAug 20, 2019
Details
- NPI
- 1629633797
- Entity type
- Individual (NPI-1)
- Name
- Braxton Lucero
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 4, 2019
- Last updated
- Aug 20, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 25MP00534400 | NJ | Yes |
Practice location
1 Clara Maass DrBelleville, NJ 07109-3550
Phone 973-450-2000
Mailing address
30 Ardsley CtEast Brunswick, NJ 08816-3673
Phone 801-458-9687
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All 51 Physician Assistant providers in Belleville · All 794 providers in Belleville
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