Provider Demographics
NPI:1619534385
Name:PASTERNAK, LUCYNA (LMT)
Entity Type:Individual
Prefix:
First Name:LUCYNA
Middle Name:
Last Name:PASTERNAK
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4421 FOREST LN
Mailing Address - Street 2:
Mailing Address - City:SCHWENKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19473-2513
Mailing Address - Country:US
Mailing Address - Phone:610-850-3319
Mailing Address - Fax:
Practice Address - Street 1:321 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-3355
Practice Address - Country:US
Practice Address - Phone:610-850-3319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-28
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEMT-0003940225700000X
NJ18KT00746600225700000X
PAMSG009038225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist