Provider Demographics
NPI:1164506853
Name:LUKONAITIS, CAROLYN JANE (DC)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:JANE
Last Name:LUKONAITIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER CREEK
Mailing Address - State:NY
Mailing Address - Zip Code:14136-1338
Mailing Address - Country:US
Mailing Address - Phone:716-934-7772
Mailing Address - Fax:716-934-4971
Practice Address - Street 1:194 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SILVER CREEK
Practice Address - State:NY
Practice Address - Zip Code:14136-1338
Practice Address - Country:US
Practice Address - Phone:716-934-7772
Practice Address - Fax:716-934-4971
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0105280B111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY693171OtherEMPIRE MPN
NY8812992OtherINDENDENT HEALTH
NY693171OtherEMPIRE MPN
NY8812992OtherINDENDENT HEALTH