Healthcare Provider Details

I. General information

NPI: 1700599214
Provider Name (Legal Business Name): JULIA LUCZKOW CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2022
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CLIFFMINE RD STE 500
PITTSBURGH PA
15275-1053
US

IV. Provider business mailing address

2000 CLIFFMINE RD STE 500
PITTSBURGH PA
15275-1053
US

V. Phone/Fax

Practice location:
  • Phone: 878-201-3312
  • Fax:
Mailing address:
  • Phone: 878-201-3312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberSP026817
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN.CNP.0043033
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: