Provider Demographics
NPI:1699124743
Name:PUSKI, ATHENA (MS LGC)
Entity type:Individual
Prefix:
First Name:ATHENA
Middle Name:
Last Name:PUSKI
Suffix:
Gender:F
Credentials:MS LGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:21602 PFP
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-467-6741
Mailing Address - Fax:319-467-5539
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:21602 PFP
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-467-6741
Practice Address - Fax:319-467-5539
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS