Provider Demographics
NPI:1467477588
Name:LUTSKY, JULIE ANN (PHARM D)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:LUTSKY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 BUNKER DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18706-5328
Mailing Address - Country:US
Mailing Address - Phone:570-762-7042
Mailing Address - Fax:
Practice Address - Street 1:33 PUBLIC SQ
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18701-1701
Practice Address - Country:US
Practice Address - Phone:570-762-7042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440163183500000X
VA0202207407183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist