Provider Demographics
NPI:1609800416
Name:LUKACSKO, DEBRA L (MSN, BA, RN, APN, C)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:L
Last Name:LUKACSKO
Suffix:
Gender:F
Credentials:MSN, BA, RN, APN, C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 DEERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:07416-9712
Mailing Address - Country:US
Mailing Address - Phone:973-827-5819
Mailing Address - Fax:
Practice Address - Street 1:505 RAMAPO VALLEY RD
Practice Address - Street 2:
Practice Address - City:MAHWAH
Practice Address - State:NJ
Practice Address - Zip Code:07430-1623
Practice Address - Country:US
Practice Address - Phone:201-684-7536
Practice Address - Fax:201-684-7534
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN09530400363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health