Provider Demographics
NPI:1841286697
Name:LUCAS, ROBIN STACEY (MD)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:STACEY
Last Name:LUCAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:35 CLYDE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-5033
Mailing Address - Country:US
Mailing Address - Phone:732-873-9682
Mailing Address - Fax:732-873-9683
Practice Address - Street 1:35 CLYDE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-5033
Practice Address - Country:US
Practice Address - Phone:732-873-9682
Practice Address - Fax:732-873-9683
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA050875207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6080804Medicaid
NJF43639Medicare UPIN
NJ6080804Medicaid