Provider Demographics
NPI:1528381829
Name:LUK, PHILIP
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:LUK
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 1:24821 88TH DR
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426-2031
Mailing Address - Country:US
Mailing Address - Phone:347-622-1503
Mailing Address - Fax:718-480-6447
Practice Address - Street 1:24821 88TH DR
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-2031
Practice Address - Country:US
Practice Address - Phone:347-622-1503
Practice Address - Fax:718-480-6447
Is Sole Proprietor?:No
Enumeration Date:2010-03-01
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053117183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist