Active NPI
John D Luetzow, PH D
- Psychologist
- Erdenheim, PA
National Provider Identifier
1346355088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS008042L
- Practice address
- 808 Bethlehem Pike
Suite 5
Erdenheim, PA 19038-8110 - Phone
- (215) 836-1582
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS008042L | PA | Primary |
Addresses
Primary practice location
808 Bethlehem Pike
Suite 5
Erdenheim, PA 19038-8110
Mailing address
808 Bethlehem Pike
Suite 5
Erdenheim, PA 19038-8110
Phone (215) 836-1582
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS008042L | PA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194393600000",
"number": "1346355088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "808 BETHLEHEM PIKE",
"address_2": "SUITE 5",
"city": "ERDENHEIM",
"state": "PA",
"postal_code": "190388110",
"telephone_number": "215-836-1582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "808 BETHLEHEM PIKE",
"address_2": "SUITE 5",
"city": "ERDENHEIM",
"state": "PA",
"postal_code": "190388110",
"telephone_number": "215-836-1582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUETZOW",
"first_name": "JOHN",
"middle_name": "D",
"credential": "PH D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2007-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS008042L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Erdenheim, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.