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Individual

DANIEL LUCZKOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
49 BURSLEY PATH, WEST BARNSTABLE, MA 02668-1361
(508) 292-4270
Mailing address
49 BURSLEY PATH, WEST BARNSTABLE, MA 02668-1361
(508) 292-4270

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
223191
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2103834
MA
01
J29442
BLUE SHIELD
MA
Enumeration date
05/11/2006
Last updated
01/21/2009
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