Provider Demographics
NPI:1396390092
Name:LUKOMSKY, ANDRIY (DPT)
Entity Type:Individual
Prefix:
First Name:ANDRIY
Middle Name:
Last Name:LUKOMSKY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 212
Mailing Address - Street 2:
Mailing Address - City:MENDON
Mailing Address - State:NY
Mailing Address - Zip Code:14506-0212
Mailing Address - Country:US
Mailing Address - Phone:585-582-6085
Mailing Address - Fax:
Practice Address - Street 1:60 FINN RD STE C
Practice Address - Street 2:
Practice Address - City:HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14467-9393
Practice Address - Country:US
Practice Address - Phone:585-444-0040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist