Provider Demographics
NPI:1861211484
Name:SCHUCK, LUCILLE L (MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:LUCILLE
Middle Name:L
Last Name:SCHUCK
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:MS
Other - First Name:LUCILLE
Other - Middle Name:L
Other - Last Name:SCHUCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1850 BRISTOL RD
Mailing Address - Street 2:
Mailing Address - City:CHURCHVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18966-4617
Mailing Address - Country:US
Mailing Address - Phone:215-932-7747
Mailing Address - Fax:
Practice Address - Street 1:1850 BRISTOL RD
Practice Address - Street 2:
Practice Address - City:CHURCHVILLE
Practice Address - State:PA
Practice Address - Zip Code:18966-4617
Practice Address - Country:US
Practice Address - Phone:215-932-7747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN000299133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered