Provider Demographics
NPI:1851710784
Name:LUKE, OFURE R (MD)
Entity Type:Individual
Prefix:
First Name:OFURE
Middle Name:R
Last Name:LUKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OFURE
Other - Middle Name:R
Other - Last Name:ILOGIENBOH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:65 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3947
Mailing Address - Country:US
Mailing Address - Phone:732-321-7070
Mailing Address - Fax:732-321-7330
Practice Address - Street 1:65 JAMES ST
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820
Practice Address - Country:US
Practice Address - Phone:732-321-7070
Practice Address - Fax:732-321-7330
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10307400208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation