Provider Demographics
NPI:1104605781
Name:LUX, NATALIE
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:LUX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ROMA DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2128
Mailing Address - Country:US
Mailing Address - Phone:860-670-7484
Mailing Address - Fax:
Practice Address - Street 1:6 JACQUELINE WAY APT 203
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-4089
Practice Address - Country:US
Practice Address - Phone:860-670-7484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program