MEDICARE: MARIA ELIZABETH LUCZKOW MSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CW012009	PA

General Provider Information

NPI Number	:	1215008446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA ELIZABETH LUCZKOW MSW, LCSW

Provider Business Mailing Address
First Line	:	3221 MAYER DR
Second Line	:
City	:	MURRYSVILLE
State	:	PA
Zip	:	15668-1617
Country	:	US
Telephone Number	:	724-327-3352
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 DUFF RD
Second Line	:	SUITE 301
City	:	PITTSBURGH
State	:	PA
Zip	:	15235-3260
Country	:	US
Telephone Number	:	412-731-9707
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2006
Last Update Date	:	07/08/2007

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