Provider Demographics
NPI:1649815457
Name:MONICA LUTHRA
Entity type:Organization
Organization Name:MONICA LUTHRA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUTHRA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:716-839-1161
Mailing Address - Street 1:2075 KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SNYDER
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4722
Mailing Address - Country:US
Mailing Address - Phone:716-839-1161
Mailing Address - Fax:716-839-1216
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:716-839-1216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty