Provider Demographics
NPI:1528955218
Name:LUTZER, JULIANA AUGUSTINA (PA-C)
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:AUGUSTINA
Last Name:LUTZER
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:115 BENT OAK TRL
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-8948
Mailing Address - Country:US
Mailing Address - Phone:585-755-1647
Mailing Address - Fax:
Practice Address - Street 1:34 MAPLE ST
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-3894
Practice Address - Country:US
Practice Address - Phone:203-852-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical