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General NPI Number Information
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NPI Number | 1710549993
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Entity Type | Individual
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Provider Name | SARA LUCZKIEWICZ MD
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Gender | Female
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Dates
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Enumeration Date | 07/08/2019
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 452 OLD STREET RD
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City | PETERBOROUGH
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State | NH
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Zip | 03458-1295
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Country | US
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Telephone | 603-588-4200
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Fax | 603-588-4089
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Provider Business Mailing Address
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Address Line | 12 ELM ST
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City | ANTRIM
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State | NH
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Zip | 03440-3916
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Country | US
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Telephone | 603-588-4200
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Fax | 603-588-4089
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 22846
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License Number State | NH
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