Provider Demographics
NPI:1316566250
Name:LEGAKIS, LUKE PETER
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:PETER
Last Name:LEGAKIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 208013
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520-8013
Mailing Address - Country:US
Mailing Address - Phone:203-785-4170
Mailing Address - Fax:203-785-3229
Practice Address - Street 1:6 DEVINE ST
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-2195
Practice Address - Country:US
Practice Address - Phone:203-287-6200
Practice Address - Fax:203-287-6101
Is Sole Proprietor?:No
Enumeration Date:2020-04-10
Last Update Date:2023-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program