Provider Demographics
NPI:1538188743
Name:VINCENT LUCENTE MD F A C O G PC
Entity type:Organization
Organization Name:VINCENT LUCENTE MD F A C O G PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:R
Authorized Official - Last Name:LUCENTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-435-9575
Mailing Address - Street 1:3050 HAMILTON BLVD.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-3628
Mailing Address - Country:US
Mailing Address - Phone:610-435-9575
Mailing Address - Fax:610-435-2763
Practice Address - Street 1:3050 HAMILTON BLVD.
Practice Address - Street 2:SUITE 200
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-3628
Practice Address - Country:US
Practice Address - Phone:610-435-9575
Practice Address - Fax:610-435-2763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2052999000OtherINDEPENDANCE BLUE CROSS
PA1360068OtherHIGHMARK BLUE SHIELD GROU
PA03233300OtherCAPITAL BLUE CROSS GROUP
PA1360068OtherHIGHMARK BLUE SHIELD GROU