Provider Demographics
NPI:1982935987
Name:CAREY, LUKE R (PAC)
Entity Type:Individual
Prefix:MR
First Name:LUKE
Middle Name:R
Last Name:CAREY
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4059
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07474-4059
Mailing Address - Country:US
Mailing Address - Phone:973-826-8080
Mailing Address - Fax:866-309-3354
Practice Address - Street 1:695 US HIGHWAY 46
Practice Address - Street 2:SUITE 400A
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-1592
Practice Address - Country:US
Practice Address - Phone:973-826-8080
Practice Address - Fax:866-309-3354
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00231000363A00000X, 363AS0400X
MDC05070363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant