Provider Demographics
NPI:1841519329
Name:CZERWONKA, LUKASZ (MD)
Entity type:Individual
Prefix:DR
First Name:LUKASZ
Middle Name:
Last Name:CZERWONKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1554
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-0988
Mailing Address - Country:US
Mailing Address - Phone:631-444-8410
Mailing Address - Fax:631-444-7635
Practice Address - Street 1:HSC T19 020
Practice Address - Street 2:STONY BROOK MEDICINE
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8191
Practice Address - Country:US
Practice Address - Phone:631-444-8410
Practice Address - Fax:631-444-7635
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2818402086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology