Provider Demographics
NPI:1710192232
Name:SLUTSKY, LUCY (DMD)
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:
Last Name:SLUTSKY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:LUDMILA
Other - Middle Name:
Other - Last Name:SLUTSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:237 E CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4206
Mailing Address - Country:US
Mailing Address - Phone:973-736-3114
Mailing Address - Fax:973-736-5450
Practice Address - Street 1:100 NORTHFIELD AVE
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-4702
Practice Address - Country:US
Practice Address - Phone:973-736-3114
Practice Address - Fax:973-736-5450
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI020021122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist