Provider Demographics
NPI:1659603314
Name:LUKIN, FAITH TERI (NP)
Entity Type:Individual
Prefix:MS
First Name:FAITH
Middle Name:TERI
Last Name:LUKIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 LIBERTY ST
Mailing Address - Street 2:TIME INC. MEDICAL 04.S205
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10281-1008
Mailing Address - Country:US
Mailing Address - Phone:212-522-4325
Mailing Address - Fax:212-522-1919
Practice Address - Street 1:225 LIBERTY ST
Practice Address - Street 2:TIME INC. MEDICAL 04.S205
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10281-1008
Practice Address - Country:US
Practice Address - Phone:212-522-4325
Practice Address - Fax:212-522-1919
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYE330098-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily