Individual
AMY LUCKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1300 YORK AVE, NEW YORK, NY 10065-4805
(212) 746-5454
Mailing address
1300 YORK AVE, NEW YORK, NY 10065-4805
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
019821-1
NY
Other
Enumeration date
08/25/2016
Last updated
08/25/2016
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