Individual
DR. CAROL ANNE B LUCHANKO-GANLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
402 BAYARD RD, SUITE 200, KENNETT SQUARE, PA 19348-1862
(484) 770-8132
Mailing address
109 HILLSIDE LN, KENNETT SQUARE, PA 19348-2267
(610) 444-6703
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000361
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
481772
AETNA PROVIDER ID
PA
01
—
OEG000361
STATE OPTOMETRY LICENSE
PA
Enumeration date
06/16/2005
Last updated
03/07/2023
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