Provider Demographics
NPI:1043927361
Name:LUCHE, DEAN ROXANNE T (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:DEAN ROXANNE
Middle Name:T
Last Name:LUCHE
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:273 W 138TH ST APT 4A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10030-2168
Mailing Address - Country:US
Mailing Address - Phone:347-784-6404
Mailing Address - Fax:
Practice Address - Street 1:833 58TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3609
Practice Address - Country:US
Practice Address - Phone:718-290-2919
Practice Address - Fax:718-290-9860
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048148225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist