Organization
DMITRI N. LUKE, D.P.M. L.L.C.
Active
Other names
Montvale Podiatry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DMITRI N. LUKE D.P.M. (OWNER)
(201) 573-0555
Entity
Organization
Contact information
Practice address
26 N KINDERKAMACK RD, MONTVALE, NJ 07645-2109
(201) 573-0555
(201) 476-1349
Mailing address
26 N KINDERKAMACK RD, MONTVALE, NJ 07645-2109
(201) 573-0555
(201) 476-1349
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
25MD00295700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
175978
MEDICARE PTAN
NJ
Enumeration date
11/30/2011
Last updated
11/30/2011
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