Provider Demographics
NPI:1477683431
Name:ANEKE, LUKE N (MD)
Entity Type:Individual
Prefix:DR
First Name:LUKE
Middle Name:N
Last Name:ANEKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 TIEBOUT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-3149
Mailing Address - Country:US
Mailing Address - Phone:718-365-0004
Mailing Address - Fax:718-365-0008
Practice Address - Street 1:2115 TIEBOUT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-3149
Practice Address - Country:US
Practice Address - Phone:718-365-0004
Practice Address - Fax:718-365-0008
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1795031207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01177839Medicaid
NY68F251Medicare ID - Type Unspecified
NY01177839Medicaid