Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 250336 | NY |
NPI | 1730313685 |
---|---|
Provider Name | Dr. Debra Lynn Luczkiewicz |
First Address | Cheektowaga, NY 14227-1416 |
Second Address | Cheektowaga, NY 14227-1416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2009 |
Last Update Date | 25/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03120321 | (05) | NY |