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General NPI Number Information
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NPI Number | 1417137381
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Entity Type | Organization
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Legal Business Name | YEVGENIA LUKOVSKY
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Dates
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Enumeration Date | 11/08/2007
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 10890 BUSTLETON AVE SUITE 100
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City | PHILADELPHIA
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State | PA
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Zip | 19116-3313
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Country | US
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Telephone | 215-676-7622
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Fax | 215-934-7822
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Provider Business Mailing Address
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Address Line | 10890 BUSTLETON AVE SUITE 100
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City | PHILADELPHIA
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State | PA
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Zip | 19116-3313
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Country | US
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Telephone | 215-676-7622
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Fax | 215-934-7822
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Authorized Official
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Title or Position | OWNER
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Name | YEVGENIA LUKOVSKY
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Credential |
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Telephone | 215-676-7622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State | PA
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