Provider Demographics
NPI:1326079575
Name:LUKASKO, ERICA (OD)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:
Last Name:LUKASKO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4906 AMBASSADOR CAFFERY PKWY
Mailing Address - Street 2:SUITE 701, BUILDING G
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6962
Mailing Address - Country:US
Mailing Address - Phone:337-989-2600
Mailing Address - Fax:337-993-2920
Practice Address - Street 1:4906 AMBASSADOR CAFFERY PKWY BLDG G
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6962
Practice Address - Country:US
Practice Address - Phone:337-989-2600
Practice Address - Fax:337-993-2920
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA#1392-523T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist