Provider Demographics
NPI:1154543437
Name:LUCENTE, SONDRA G (MS)
Entity type:Individual
Prefix:MS
First Name:SONDRA
Middle Name:G
Last Name:LUCENTE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 HELEN WAY
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-1542
Mailing Address - Country:US
Mailing Address - Phone:215-837-5090
Mailing Address - Fax:
Practice Address - Street 1:22 HELEN WAY
Practice Address - Street 2:
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922-1542
Practice Address - Country:US
Practice Address - Phone:215-837-5090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015107-1235Z00000X
NJ41YS00528500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3961769OtherAETNA HMO
NY7831703Medicare UPIN