Individual
COREY LEE LUKSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
37 POLK ST, FREEPORT, NY 11520-6223
(516) 729-1064
Mailing address
37 POLK ST, FREEPORT, NY 11520-6223
(516) 729-1064
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
020490
NY
Other
Enumeration date
04/08/2016
Last updated
04/08/2016
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