Provider Demographics
NPI:1497369623
Name:LUBA, ALEKSANDRA (AVD)
Entity Type:Individual
Prefix:
First Name:ALEKSANDRA
Middle Name:
Last Name:LUBA
Suffix:
Gender:F
Credentials:AVD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 MONTGOMERY AVENUE
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072
Mailing Address - Country:US
Mailing Address - Phone:610-667-3277
Mailing Address - Fax:610-667-1662
Practice Address - Street 1:916 MONTGOMERY AVENUE
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072
Practice Address - Country:US
Practice Address - Phone:610-667-3277
Practice Address - Fax:610-667-3277
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006705237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter