Individual
ELIZABETH LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4644 MERRICK RD, MASSAPEQUA, NY 11758-6030
(516) 860-6659
Mailing address
99 SHOREHAM RD, MASSAPEQUA, NY 11758-7358
(516) 860-6659
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
007789
NY
Other
Enumeration date
03/04/2018
Last updated
03/04/2018
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