Basic Information
| Provider Information | |||||||||
| NPI: | 1740542372 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LIPORACI-LUCENA | ||||||||
| FirstName: | JORGE | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4601 FLAT ROCK RD | ||||||||
| Address2: | APT 301 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191272027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2673856113 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4735 OGLETOWN STANTON RD | ||||||||
| Address2: | SUITE 3301 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197132072 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026234370 | ||||||||
| FaxNumber: | 3026234375 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2012 | ||||||||
| LastUpdateDate: | 01/03/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | MT189425 | PA | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | C1-0010558 | DE | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0102X | C1-0010558 | DE | Y | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care |
No ID Information.