Provider Demographics
NPI:1780731398
Name:LUTZ, TERRY FRANCIS (OD)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:FRANCIS
Last Name:LUTZ
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:710 HORATIO ST UNIT Z4
Mailing Address - Street 2:VISION CENTER
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-1400
Mailing Address - Country:US
Mailing Address - Phone:315-733-7339
Mailing Address - Fax:315-849-2166
Practice Address - Street 1:710 HORATIO ST UNIT Z4
Practice Address - Street 2:VISION CENTER
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-1400
Practice Address - Country:US
Practice Address - Phone:315-733-7339
Practice Address - Fax:315-849-2166
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2015-07-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY3819152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00725860Medicaid
NY00725860Medicaid
NYJ300014022Medicare PIN
NYJ400007644Medicare PIN