Provider Demographics
NPI:1619246550
Name:LUFT, VERONICA BRESCIA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:BRESCIA
Last Name:LUFT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:VERONICA
Other - Middle Name:NOELLE
Other - Last Name:BRESCIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPN
Mailing Address - Street 1:74 TWIN LAKES TRL
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12721-4946
Mailing Address - Country:US
Mailing Address - Phone:845-705-2411
Mailing Address - Fax:
Practice Address - Street 1:74 TWIN LAKES TRL
Practice Address - Street 2:
Practice Address - City:BLOOMINGBURG
Practice Address - State:NY
Practice Address - Zip Code:12721-4946
Practice Address - Country:US
Practice Address - Phone:845-705-2411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY298773164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse