Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 225870 | MA |
N | 208600000X | Surgeon | 225870 | MA |
Y | 2086S0102X | Surgical Critical Care | MD14003 | RI |
NPI | 1073730065 |
---|---|
Provider Name | Dr. Stephanie N Lueckel |
First Address | Rumford, RI 02916-0697 |
Second Address | Providence, RI 02903-4923 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 29/01/2020 |