Provider Demographics
NPI:1417643214
Name:LUTWAK, NOY (DO)
Entity Type:Individual
Prefix:
First Name:NOY
Middle Name:
Last Name:LUTWAK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:NOY
Other - Middle Name:
Other - Last Name:LASKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:950 BAYBERRY POINT DR
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3507
Mailing Address - Country:US
Mailing Address - Phone:954-465-3328
Mailing Address - Fax:
Practice Address - Street 1:703 N FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1006
Practice Address - Country:US
Practice Address - Phone:786-651-6653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-14
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program