Provider Demographics
NPI:1871761452
Name:PHILIP F. LUKOFF DPM PC
Entity type:Organization
Organization Name:PHILIP F. LUKOFF DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:F
Authorized Official - Last Name:LUKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:508-650-3668
Mailing Address - Street 1:192 WORCESTER RD
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-2252
Mailing Address - Country:US
Mailing Address - Phone:508-650-3668
Mailing Address - Fax:508-650-1159
Practice Address - Street 1:192 WORCESTER RD
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-2252
Practice Address - Country:US
Practice Address - Phone:508-650-3668
Practice Address - Fax:508-650-1159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1735213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY77136OtherBLUE CROSS