Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 1735 | MA |
NPI | 1407817992 |
---|---|
Provider Name | Dr. Philip Faber Lukoff |
First Address | Natick, MA 01760-2252 |
Second Address | Natick, MA 01760-2252 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2006 |
Last Update Date | 08/07/2007 |