STEPHEN BRANDON LUCZAK


Address: 263 Farmington Ave., Farmington, CT 06030-4037
Phone: 8606796645

STEPHEN BRANDON LUCZAK (NPI# 1154700854) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1154700854
Entity Type Individual
Full Name STEPHEN BRANDON LUCZAK
Credential M.D.
Practice Address 263 Farmington Ave.
Farmington
CT 06030-4037
Mailing Address 263 Farmington Ave
Farmington
CT 06030-4037
Practice Telephone 8606796645
Practice Fax Number 8606796649
Mailing Telephone 8606796645
Mailing Fax Number 8606796649
Enumeration Date 2015-05-27
Last Update Date 2020-08-05
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207X00000X Orthopaedic Surgery 4301107440 MI Allopathic & Osteopathic Physicians
Y 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Provider Secondary Practice Location

Address Telephone Number Fax Number
3535 W 13 Mile Rd, Ste 744, Royal Oak, MI 480736770 2485513140

Office Location

Street Address 263 FARMINGTON AVE.
City FARMINGTON
State CT
Zip Code 06030-4037

Providers in the same location

NPI Name Taxonomy Address Enumeration
1619155231 Salvatore J Marino Perfusionist 263 Farmington Ave., Farmington, CT 06030-2212 2008-02-06
1790199214 Joel Andrew Calafell Student in an Organized Health Care Education/Training Program 263 Farmington Ave., Uconn School of Medicine Department of Surgery, Farmington, CT 06030-3955 2014-06-12
1447504766 Mary E Davison-price Nurse Practitioner 263 Farmington Ave., Farmington, CT 06030 2012-11-08

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1821617606 David Wozny Student in an Organized Health Care Education/Training Program General Medicine Clinic, Outpatient Pavillion-2 East, 263 Farmington Ave, Farmington, CT 06030 2020-04-13
1508495185 Zachary Boivin Student in an Organized Health Care Education/Training Program Emergency Medicine Office, 263 Farmington Ave, Farmington, CT 06030 2020-04-06
1063903730 Agura Afiari Student in an Organized Health Care Education/Training Program Uconn School of Medicine, 263 Farmington Avenue, Farmington, CT 06030 2018-05-29
1750879474 Areeba Siddiqui Student in an Organized Health Care Education/Training Program 263 Farmington Avenue Mc1921, Farmington, CT 06030 2018-04-27
1508362013 Arya Saniee I Student in an Organized Health Care Education/Training Program 264 Farmington Ave, Farmington, CT 06030 2018-04-03
1679828594 Randall Morera Student in an Organized Health Care Education/Training Program 262 Farmington Ave, Farmington, CT 06030 2012-07-17
1750644365 Ugonna Ijeoma Student in an Organized Health Care Education/Training Program 260 Farmington Ave, Farmington, CT 06030 2012-06-19
1407018419 Julia Marie Toto Plastic Surgery University Physicians, 263 Farmington Avenue, Farmington, CT 06030 2008-06-30
1851456495 Jeffrey Gross Anesthesiology 263 Farmington Avenue, Mc-2015, John Dempsey Hospital, Farmington, CT 06030 2006-12-26
1649225269 Julian Nieves Internal Medicine 263 Famrington Avenue, Farmington, CT 06030 2006-05-23
Find all providers in zip 06030

Taxonomy Information

Taxonomy Code 390200000X
Grouping Student, Health Care
Classification Student in an Organized Health Care Education/Training Program

Taxonomy Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Notes: [1/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1255949459 Tamara Wittrock Student in an Organized Health Care Education/Training Program 5111 Robin Ln, Farmington, MN 55024-2007 2020-07-14
1700401759 William Cody Alley Student in an Organized Health Care Education/Training Program 1136 Heather Cir, Farmington, UT 84025-4305 2020-06-15
1497370456 Tanner Winger Student in an Organized Health Care Education/Training Program 1405 Fairway Cir, Farmington, UT 84025-2817 2020-06-15
1154945855 Shelby Ann Oswald Student in an Organized Health Care Education/Training Program 19976 Butternut Trl, Farmington, MN 55024-1475 2020-05-29
1417579434 Herbert E Downton Ramos Student in an Organized Health Care Education/Training Program Surgery Residency Program, 263 Farmington Avenue, Farmington, CT 06030-8073 2020-05-13
1710507272 Ethan A Miller Student in an Organized Health Care Education/Training Program Uconn School of Medicine - Graduate Medical Education, 263 Farmington Avenue - Lm068, Farmington, CT 06030-1921 2020-04-24
1821617606 David Wozny Student in an Organized Health Care Education/Training Program General Medicine Clinic, Outpatient Pavillion-2 East, 263 Farmington Ave, Farmington, CT 06030 2020-04-13
1265061808 Benjamin Mucci Student in an Organized Health Care Education/Training Program 43 Portage Xing, Farmington, CT 06032-2737 2020-04-06
1508495185 Zachary Boivin Student in an Organized Health Care Education/Training Program Emergency Medicine Office, 263 Farmington Ave, Farmington, CT 06030 2020-04-06
1508499435 Kelsey Erin Boyne Student in an Organized Health Care Education/Training Program 200 Academic Way, Farmington, CT 06032 2020-02-19
Find all providers in FARMINGTON

Competitor

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City FARMINGTON
Zip Code 06030

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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