1588790778 NPI number — MS. JANE WINFORD LUKE LSCW, BCD

Table of content: MS. JANE WINFORD LUKE LSCW, BCD (NPI 1588790778)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588790778 NPI number — MS. JANE WINFORD LUKE LSCW, BCD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LUKE
Provider First Name:
JANE
Provider Middle Name:
WINFORD
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LSCW, BCD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588790778
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
104 CAPITOL PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWARK
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19711-4706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-368-7520
Provider Business Mailing Address Fax Number:
302-368-1184

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
523 CAPITOL TRL
Provider Second Line Business Practice Location Address:
WORKCARE, WINDY HILLS PROFESSIONAL CENTER
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19711-3859
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-368-1184
Provider Business Practice Location Address Fax Number:
302-368-1184
Provider Enumeration Date:
02/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  Q1-0000220 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 104100000X , with the licence number: BCD 10511 ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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