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General NPI Number Information
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NPI Number | 1528955218
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Entity Type | Individual
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Provider Name | JULIANA AUGUSTINA LUTZER PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 34 MAPLE ST
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City | NORWALK
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State | CT
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Zip | 06850-3894
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Country | US
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Telephone | 203-852-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 115 BENT OAK TRL
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City | FAIRPORT
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State | NY
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Zip | 14450-8948
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Country | US
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Telephone | 585-755-1647
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 23.007221
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License Number State | CT
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