Provider Demographics
NPI:1750274940
Name:LUCZEJKO, TASHA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TASHA
Middle Name:
Last Name:LUCZEJKO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4109 PAWNEE CT
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2069
Mailing Address - Country:US
Mailing Address - Phone:610-349-6566
Mailing Address - Fax:610-349-6566
Practice Address - Street 1:6520 STONEGATE DR STE 100
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9297
Practice Address - Country:US
Practice Address - Phone:610-794-5380
Practice Address - Fax:610-794-5415
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441859183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist