Provider Demographics
NPI:1588976542
Name:LUTZKY, ALICIA (HIS)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:
Last Name:LUTZKY
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 619
Mailing Address - Street 2:821 N. BETHLEHEM PIKE, BLUE BELL HEARING AID CENTER INC
Mailing Address - City:SPRING HOUSE
Mailing Address - State:PA
Mailing Address - Zip Code:19477-0619
Mailing Address - Country:US
Mailing Address - Phone:215-641-1317
Mailing Address - Fax:215-641-0677
Practice Address - Street 1:821 N. BETHLEHEM PIKE
Practice Address - Street 2:BLUE BELL HEARING AID CENTER INC.
Practice Address - City:SPRING HOUSE
Practice Address - State:PA
Practice Address - Zip Code:19477-0619
Practice Address - Country:US
Practice Address - Phone:215-641-1317
Practice Address - Fax:215-641-0677
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-07
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAF02953237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist