MEDICARE: ANNAMARIE LUKISH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1437099256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNAMARIE LUKISH

Provider Business Mailing Address
First Line	:	1004 COACHFORD CT
Second Line	:
City	:	LUTHERVILLE TIMONIUM
State	:	MD
Zip	:	21093-1600
Country	:	US
Telephone Number	:	443-545-9327
Fax Number	:

Provider Business Practice Location Address
First Line	:	4190 CITY AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-1626
Country	:	US
Telephone Number	:	215-871-6645
Fax Number	:	215-871-6695

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2026
Last Update Date	:	04/08/2026

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Directions to “ ANNAMARIE LUKISH ” Practice Location

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