1184115917 NPI number — MISS NEETI PRERANA LUKE

Table of content: MISS NEETI PRERANA LUKE (NPI 1184115917)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184115917 NPI number — MISS NEETI PRERANA LUKE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LUKE
Provider First Name:
NEETI
Provider Middle Name:
PRERANA
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
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:
1184115917
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/27/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
01/22/2019
NPI Reactivation Date:
01/31/2019

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
NASSAU UNIVERSITY MEDICAL CENTRE,
Provider Second Line Business Mailing Address:
2201 HEMPSTEAD TURNPIKE
Provider Business Mailing Address City Name:
EAST MEADOW
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11554
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-572-0123
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2525 CHICAGO AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55404-4518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-992-5316
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/29/2018

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: 208000000X , with the licence number:  311496 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2080P0207X , with the licence number: 76031 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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