Provider Demographics
NPI:1437227642
Name:DR. DAVID J LUSCHINI MD PC
Entity Type:Organization
Organization Name:DR. DAVID J LUSCHINI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:LUSCHINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-947-1987
Mailing Address - Street 1:1909 BRIARCLIFFE AVE
Mailing Address - Street 2:
Mailing Address - City:MEADOWBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19046
Mailing Address - Country:US
Mailing Address - Phone:215-947-1987
Mailing Address - Fax:215-947-5767
Practice Address - Street 1:1650 HUNTINGDON PIKE
Practice Address - Street 2:SUITE 224
Practice Address - City:MEADOWBROOK
Practice Address - State:PA
Practice Address - Zip Code:19046
Practice Address - Country:US
Practice Address - Phone:215-947-1987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0777980Medicaid
PAB34455Medicare UPIN
PA0777980Medicaid