Provider Demographics
NPI:1851876932
Name:LUTSKER, LEONA LUBOV (MS, CF-SLP-TSSLD)
Entity Type:Individual
Prefix:
First Name:LEONA
Middle Name:LUBOV
Last Name:LUTSKER
Suffix:
Gender:F
Credentials:MS, CF-SLP-TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 CORBIN PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4804
Mailing Address - Country:US
Mailing Address - Phone:718-594-7747
Mailing Address - Fax:
Practice Address - Street 1:704 AVENUE X FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6121
Practice Address - Country:US
Practice Address - Phone:718-676-6116
Practice Address - Fax:718-676-6117
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty