Provider Demographics
NPI:1437142163
Name:LUCHANSKY, CRAIG A (OD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:A
Last Name:LUCHANSKY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 LOTHROP ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2548
Mailing Address - Country:US
Mailing Address - Phone:412-647-2200
Mailing Address - Fax:
Practice Address - Street 1:203 LOTHROP ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2548
Practice Address - Country:US
Practice Address - Phone:412-647-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0EG000610152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01285040Medicaid
T72770Medicare UPIN
PA01285040Medicaid