Provider Demographics
NPI:1669352068
Name:LUCE, NATHAN DAVID
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:DAVID
Last Name:LUCE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 QUEENS WAY APT 5
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-7729
Mailing Address - Country:US
Mailing Address - Phone:415-324-0085
Mailing Address - Fax:
Practice Address - Street 1:10 QUEENS WAY APT 5
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-7729
Practice Address - Country:US
Practice Address - Phone:415-324-0085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program