Provider Demographics
NPI:1245692516
Name:LUTHRA, MONICA P (DO)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:P
Last Name:LUTHRA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 ROXBURY PARK
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1774
Mailing Address - Country:US
Mailing Address - Phone:716-812-6644
Mailing Address - Fax:
Practice Address - Street 1:2075 KENSINGTON AVE
Practice Address - Street 2:
Practice Address - City:SNYDER
Practice Address - State:NY
Practice Address - Zip Code:14226-4722
Practice Address - Country:US
Practice Address - Phone:716-839-1161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-24
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 13705207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine