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Individual

DR. BERNARD PETER LUCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
40 MATTHEWS ST STE 111, GOSHEN, NY 10924-1986
(845) 551-1208
(845) 782-5255
Mailing address
54 SOUTH ST, GOSHEN, NY 10924-2318
(845) 294-3884
(845) 294-2790

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
061375159
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00521095
NY
01
061375159
TAX IDENTIFICATION NUMBER
NY
Enumeration date
01/31/2006
Last updated
06/23/2016
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