MEDICARE: MR. TODD LUKASZEWSKI RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	3090	NH

General Provider Information

NPI Number	:	1205154564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TODD LUKASZEWSKI RPH

Provider Business Mailing Address
First Line	:	7 STONY BROOK RD
Second Line	:
City	:	GORHAM
State	:	NH
Zip	:	03581-1350
Country	:	US
Telephone Number	:	603-466-3933
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 PLEASANT ST
Second Line	:
City	:	BERLIN
State	:	NH
Zip	:	03570-2044
Country	:	US
Telephone Number	:	603-752-3952
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2010
Last Update Date	:	05/12/2010

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