Provider Demographics
NPI:1518104249
Name:LUKE EYERMAN MD, LLC
Entity Type:Organization
Organization Name:LUKE EYERMAN MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:E
Authorized Official - Last Name:EYERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-466-0938
Mailing Address - Street 1:290 LAFAYETTE AVE, STE 202
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07506-1928
Mailing Address - Country:US
Mailing Address - Phone:201-947-7642
Mailing Address - Fax:
Practice Address - Street 1:290 LAFAYETTE AVE, STE 202
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NJ
Practice Address - Zip Code:07506-1928
Practice Address - Country:US
Practice Address - Phone:201-466-0938
Practice Address - Fax:201-791-1438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty