Individual
ALYSSA MARIE LUTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
180 1ST AVE, MASSAPEQUA PARK, NY 11762-2353
(516) 965-4270
Mailing address
180 1ST AVE, MASSAPEQUA PARK, NY 11762-2353
(516) 965-4270
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/08/2021
Last updated
10/08/2021
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