Individual
LAUREN G LUKASIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2109 HUGHES DR # 760, TOLEDO, OH 43606-3858
(419) 291-2671
(419) 291-2680
Mailing address
100 MADISON AVE, TOLEDO, OH 43604-1516
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110002266
VA
363A00000X
Physician Assistant
Primary
50003243
OH
363AS0400X
Surgical Physician Assistant
50003243
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0074794
—
OH
01
—
0110002266
STATE LICENSE AS A PA
VA
Enumeration date
06/17/2006
Last updated
08/20/2024
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