Most Relevant Information
Provider Data
| NPI Number: | 1003064098 |
| Provider Name: | JERRY GARY LUCKS RPH |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 028282 |
Most Important Dates
| Enumeration Date: | 09/03/2008 |
| Last Updated: | 09/03/2008 |
Provider Practice Location
602 BRIGHTON BEACH AVE
BROOKLYN
NY
112356456
Practice Location Phone/Fax
| Phone: | 7183323708 |
| Fax: | 7183325737 |
Provider Mailing Location
602 BRIGHTON BEACH AVE
BROOKLYN
NY
112356456
Provider Mailing Phone/Fax
| Phone: | 7183323708 |
| Fax: | 7183325737 |