Healthcare Provider Details

I. General information

NPI: 1942532767
Provider Name (Legal Business Name): NANCY L LUKOWSKI RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2010
Last Update Date: 02/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5175 BROADWAY
DEPEW NY
14043-4025
US

IV. Provider business mailing address

5175 BROADWAY
DEPEW NY
14043-4025
US

V. Phone/Fax

Practice location:
  • Phone: 716-515-3435
  • Fax: 716-515-1101
Mailing address:
  • Phone: 716-515-3435
  • Fax: 716-515-1101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number043988
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: