Basic Information
| Provider Information | |||||||||
| NPI: | 1437197324 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LUCACEL | ||||||||
| FirstName: | CARLA | ||||||||
| MiddleName: | ADRIANA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4224 GREENPOINT AVE | ||||||||
| Address2: | |||||||||
| City: | SUNNYSIDE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 111043004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184826814 | ||||||||
| FaxNumber: | 7184826817 | ||||||||
| Practice Location | |||||||||
| Address1: | 4224 GREENPOINT AVE | ||||||||
| Address2: | |||||||||
| City: | SUNNYSIDE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 111043004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184826814 | ||||||||
| FaxNumber: | 7184826817 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2006 | ||||||||
| LastUpdateDate: | 02/27/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 236859 | NY | Y | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 25MA08013100 | NJ | N | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | LC6853 | 01 | NY | ATLANTIS | OTHER | 00042360914 | 01 | NY | HEALTHPLUS | OTHER | 009248-CL | 01 | NY | METROPLUS | OTHER | 217859P | 01 | NY | HIP | OTHER | 2571196 | 01 | NY | UNITEDHEALTHCARE | OTHER | 23685901 | 01 | NY | NEIGHBORHOOD | OTHER | P3663889 | 01 | NY | OXFORD | OTHER | 000000105147 | 01 | NY | GHI HMO | OTHER | 0102793-01 | 01 | NY | AMERICHOICE | OTHER | 1000037513 | 01 | NY | AFFINITY | OTHER | 2605060 | 01 | NY | GHI PPO | OTHER | 316422 | 01 | NY | WELLCARE | OTHER | 7043716 | 01 | NY | AETNA PPO | OTHER | 203253540LU01 | 01 | NY | CAREPLUS | OTHER | 236859NY | 01 | NY | 1199 NBF | OTHER | 3949387 | 01 | NY | CIGNA | OTHER | 5653922 | 01 | NY | FIRSTHEALTH | OTHER | 236859A29 | 01 | NY | HEALTHFIRST | OTHER | 2482U | 01 | NY | EMPIRE BC/BS | OTHER | 02688700 | 05 | NY | MEDICAID |