# LUKOSE MEDICAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750068276
- **Authorized official:** SIJU LUKOSE DO (OWNER)
- **Authorized official phone:** (631) 271-9151

## Contact information

- **Practice address:** 4295 HEMPSTEAD TPKE, BETHPAGE, NY 11714-5713
- **Practice address phone:** (631) 271-9151
- **Practice address fax:** (631) 271-9155
- **Mailing address:** 1662 OLD COUNTRY RD UNIT 1200, PLAINVIEW, NY 11803-7003
- **Mailing address phone:** (631) 271-9151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/28/2023
- **Last updated:** 06/28/2023