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1629633797
BRAXTON LUCERO
BELLEVILLE, NJ
NPI
1629633797
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NJ 25MP00534400)
Enumeration Date
2019-05-04
Last Update Date
2019-08-20
Business Address
BRAXTON LUCERO
1 CLARA MAASS DR
BELLEVILLE, NJ 07109-3550
Phone number: 973-450-2000
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Mailing Address
BRAXTON LUCERO
30 ARDSLEY CT
EAST BRUNSWICK, NJ 08816-3673
Phone number: 801-458-9687
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