MEDICARE: DR. ANDREW E LITUCHY MD

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	174400000X	Specialist	181585	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740287010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW E LITUCHY MD

Provider Business Mailing Address
First Line	:	PO BOX 415
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-0415
Country	:	US
Telephone Number	:	516-365-4888
Fax Number	:	516-365-4820

Provider Business Practice Location Address
First Line	:	100 PORT WASHINGTON BLVD
Second Line	:
City	:	ROSLYN
State	:	NY
Zip	:	11576-1353
Country	:	US
Telephone Number	:	516-365-4888
Fax Number	:	516-365-4820

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	10/11/2007

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