Healthcare Provider Details

I. General information

NPI: 1316566250
Provider Name (Legal Business Name): LUKE PETER LEGAKIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2020
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 EMMA LN
CLIFTON PARK NY
12065-3763
US

IV. Provider business mailing address

8 SOUTHWOODS BLVD
ALBANY NY
12211-2554
US

V. Phone/Fax

Practice location:
  • Phone: 518-383-0001
  • Fax: 518-434-0806
Mailing address:
  • Phone: 518-434-1446
  • Fax: 518-434-0806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number335701
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: