Healthcare Provider Details

I. General information

NPI: 1285820860
Provider Name (Legal Business Name): ARTHUR LUKOFF DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 10/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 N MAIN ST
ELLENVILLE NY
12428-1016
US

IV. Provider business mailing address

11 LAKE DR
ELLENVILLE NY
12428-2309
US

V. Phone/Fax

Practice location:
  • Phone: 845-647-3060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License NumberN002613
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberN002613
License Number StateNY

VIII. Authorized Official

Name: DR. ARTHUR SAUL LUKOFF
Title or Position: PODIATRIST
Credential: DPM
Phone: 845-647-3060