Provider Demographics
NPI:1235124215
Name:LUTKA, TERESA LYNN (MD)
Entity Type:Individual
Prefix:MISS
First Name:TERESA
Middle Name:LYNN
Last Name:LUTKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:TERESA
Other - Middle Name:LYNN
Other - Last Name:LUTKA-FEDOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2644 BANKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15216
Mailing Address - Country:US
Mailing Address - Phone:412-343-7166
Mailing Address - Fax:412-343-4330
Practice Address - Street 1:2644 BANKSVILLE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15216
Practice Address - Country:US
Practice Address - Phone:412-343-7166
Practice Address - Fax:412-343-4330
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-15
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4229632084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry