Provider Demographics
NPI:1083109938
Name:OSITKO, L LUCILLE
Entity Type:Individual
Prefix:
First Name:L
Middle Name:LUCILLE
Last Name:OSITKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18915 TIMBERCREEK DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:DE
Mailing Address - Zip Code:19968-3334
Mailing Address - Country:US
Mailing Address - Phone:302-864-0180
Mailing Address - Fax:
Practice Address - Street 1:18915 TIMBERCREEK DR
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:DE
Practice Address - Zip Code:19968-3334
Practice Address - Country:US
Practice Address - Phone:302-864-0180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-23
Last Update Date:2018-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0028694163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology