Provider Demographics
NPI:1790046357
Name:LUKOWSKI, ANISSA ELIZABETH (MSED)
Entity Type:Individual
Prefix:MRS
First Name:ANISSA
Middle Name:ELIZABETH
Last Name:LUKOWSKI
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:MS
Other - First Name:ANISSA
Other - Middle Name:ELIZABETH
Other - Last Name:KRAUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7430 SCOTLAND RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:NY
Mailing Address - Zip Code:14001-9605
Mailing Address - Country:US
Mailing Address - Phone:716-200-9078
Mailing Address - Fax:
Practice Address - Street 1:7430 SCOTLAND RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:NY
Practice Address - Zip Code:14001-9605
Practice Address - Country:US
Practice Address - Phone:716-200-9078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist