Provider Demographics
NPI:1407365372
Name:LUK, ROWENA
Entity Type:Individual
Prefix:
First Name:ROWENA
Middle Name:
Last Name:LUK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-3523
Mailing Address - Country:US
Mailing Address - Phone:856-336-8999
Mailing Address - Fax:
Practice Address - Street 1:1 MALL DR STE 301
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2101
Practice Address - Country:US
Practice Address - Phone:856-336-8999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-23
Last Update Date:2023-08-21
Deactivation Date:2018-02-02
Deactivation Code:
Reactivation Date:2023-08-21
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00097100171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist