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General NPI Number Information
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NPI Number | 1750905048
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Entity Type | Individual
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Provider Name | YEVGENIY LUTS DO
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Gender | Male
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Dates
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Enumeration Date | 06/02/2020
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 6981 N PARK DR STE 300A
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City | PENNSAUKEN
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State | NJ
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Zip | 08109-4205
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Country | US
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Telephone | 856-854-4524
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Fax |
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Provider Business Mailing Address
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Address Line | 301 LIPPINCOTT DR STE 410
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City | MARLTON
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State | NJ
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Zip | 08053-4197
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Country | US
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Telephone | 856-855-0340
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25MB12408700
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License Number State | NJ
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