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NPI Code Detail

MEDICARE: MARJORIE M. LUCKEY M.D.

MEDICARE:   MARJORIE M. LUCKEY  M.D.
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
1207RE0101XEndocrinology, Diabetes & Metabolism Physician25MA06661600NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902800568
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARJORIE M. LUCKEY M.D.
Provider Business Mailing Address
First Line : 1050 GALLOPING HILL RD
Second Line :
City : UNION
State : NJ
Zip : 07083-7983
Country : US
Telephone Number : 908-206-2230
Fax Number : 908-206-2237
Provider Business Practice Location Address
First Line : 200 S ORANGE AVE
Second Line :
City : LIVINGSTON
State : NJ
Zip : 07039-5817
Country : US
Telephone Number : 973-322-7430
Fax Number : 973-322-7460
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2005
Last Update Date : 07/11/2007

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Directions to “ MARJORIE M. LUCKEY M.D.” Practice Location

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