Provider Demographics
NPI:1316108723
Name:LUSHKO, SHAUNA B (OD)
Entity type:Individual
Prefix:DR
First Name:SHAUNA
Middle Name:B
Last Name:LUSHKO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:2107 N FRANKLIN DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-5868
Mailing Address - Country:US
Mailing Address - Phone:724-222-3937
Mailing Address - Fax:724-222-7570
Practice Address - Street 1:2107 N FRANKLIN DR
Practice Address - Street 2:SUITE 1
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-5868
Practice Address - Country:US
Practice Address - Phone:724-222-3937
Practice Address - Fax:724-222-7570
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOEG002044152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist