Provider Demographics
NPI:1093555013
Name:BERRY, LUCY ZARINA
Entity type:Individual
Prefix:MRS
First Name:LUCY
Middle Name:ZARINA
Last Name:BERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LUCY
Other - Middle Name:ZARINA
Other - Last Name:BERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9720 KINGS HWY APT 604
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-8514
Mailing Address - Country:US
Mailing Address - Phone:347-373-9095
Mailing Address - Fax:
Practice Address - Street 1:9720 KINGS HWY APT 604
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-8514
Practice Address - Country:US
Practice Address - Phone:347-373-9095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No172A00000XOther Service ProvidersDriver