Provider Demographics
NPI:1336353382
Name:LUCHSINGER, JOHN T (PT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:T
Last Name:LUCHSINGER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:319 MIDDLE COUNTRY RD
Mailing Address - Street 2:STE 4
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2819
Mailing Address - Country:US
Mailing Address - Phone:631-265-6326
Mailing Address - Fax:631-265-5893
Practice Address - Street 1:319 MIDDLE COUNTRY RD
Practice Address - Street 2:STE 4
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2819
Practice Address - Country:US
Practice Address - Phone:631-265-6326
Practice Address - Fax:631-265-5893
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY008996-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQN9561Medicare PIN