Provider Demographics
NPI:1942711858
Name:JUNGER, LUKASZ W (APRN)
Entity Type:Individual
Prefix:
First Name:LUKASZ
Middle Name:W
Last Name:JUNGER
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 HOPMEADOW ST STE 208
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-2299
Mailing Address - Country:US
Mailing Address - Phone:860-578-2215
Mailing Address - Fax:209-318-3113
Practice Address - Street 1:760 HOPMEADOW ST STE 208
Practice Address - Street 2:
Practice Address - City:SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06070-2299
Practice Address - Country:US
Practice Address - Phone:860-578-2215
Practice Address - Fax:209-318-3113
Is Sole Proprietor?:No
Enumeration Date:2017-10-18
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12.007332363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health