Healthcare Provider Details

I. General information

NPI: 1376565887
Provider Name (Legal Business Name): CHRISTINA ZANE LUCZYNSKI AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA LEIGH ZANE M.C.D., CCC-A

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 HOSPITAL DR SUITE 100A
STOCKBRIDGE GA
30281-9075
US

IV. Provider business mailing address

1101 HOSPITAL DR SUITE 100A
STOCKBRIDGE GA
30281-9075
US

V. Phone/Fax

Practice location:
  • Phone: 770-474-7416
  • Fax: 770-692-0761
Mailing address:
  • Phone: 770-474-7416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD003687
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: