Healthcare Provider Details

I. General information

NPI: 1093628844
Provider Name (Legal Business Name): MAX LUTSKIY ALLERGY ASTHMA CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 WASHINGTON ST STE 205
NEWTON MA
02462-1602
US

IV. Provider business mailing address

2000 WASHINGTON ST STE 205
NEWTON MA
02462-1602
US

V. Phone/Fax

Practice location:
  • Phone: 617-527-3440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MAXIM LUTSKIY
Title or Position: PRESIDENT
Credential: MD PHD
Phone: 617-818-3118