MEDICARE: MRS. ERICA LUKASKO O.D.

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	152W00000X	Optometrist	LA#1392-523T	LA

General Provider Information

NPI Number	:	1326079575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERICA LUKASKO O.D.

Provider Business Mailing Address
First Line	:	4906 AMBASSADOR CAFFERY PKWY
Second Line	:	SUITE 701, BUILDING G
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-6962
Country	:	US
Telephone Number	:	337-989-2600
Fax Number	:	337-993-2920

Provider Business Practice Location Address
First Line	:	4906 AMBASSADOR CAFFERY PKWY BLDG G
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-6962
Country	:	US
Telephone Number	:	337-989-2600
Fax Number	:	337-993-2920

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	12/20/2016

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