| Doctor Name: | MARK LUCKEY GUSTINA |
| NPI Number: | 1295945178 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MS/ CCC-A |
| License Number: | AT005835 |
| Business Practice Address: | 100 Northpointe Cir Suite 302 Seven Fields, PA - 160467851 |
| Business Phone Number: | 7247794444 |
| Business Fax Number: | |
| Mailing Address: | 6715 Little River Tpke, Suite 203 ANNANDALE |
| State: | VA |
| Postal Code: | 220033546 |
| Phone Number: | 7039425844 |
| Fax Number: | 8153663175 |
| NPI Enumeration Date: | 05/22/2007 |
| NPI Last Update Date: | 12/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 237600000X |
| License Number: | AT005835 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Audiologist-Hearing Aid Fitter |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An audiologist/hearing aid fitter is the professional who specializes in evaluating and treating people with hearing loss, conducts a wide variety of tests to determine the exact nature of an individual |