Provider Demographics
NPI:1528236783
Name:SEMERCIYAN, LUCIE A
Entity type:Individual
Prefix:MRS
First Name:LUCIE
Middle Name:A
Last Name:SEMERCIYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:461 BRINKERHOFF AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-1651
Mailing Address - Country:US
Mailing Address - Phone:201-941-1831
Mailing Address - Fax:
Practice Address - Street 1:816 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-1311
Practice Address - Country:US
Practice Address - Phone:201-891-8706
Practice Address - Fax:844-224-6918
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045796183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist