Provider Demographics
NPI:1558575340
Name:LUKSIK, STEPHANIE (PT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:LUKSIK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 PERRY HWY
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-2123
Mailing Address - Country:US
Mailing Address - Phone:412-366-3880
Mailing Address - Fax:412-366-7655
Practice Address - Street 1:1033 PERRY HWY
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-2123
Practice Address - Country:US
Practice Address - Phone:412-366-3880
Practice Address - Fax:412-366-7655
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006593L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000561754OtherBLUE SHIELD
PA0745463000OtherHEALTH AMERICA
PA023975Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
PA000561754OtherBLUE SHIELD