Organization Active NPI

South Orange Gynecology PC

  • Gynecology Physician
  • Monroe, NY
National Provider Identifier
1003907072
Registry record updated Sep 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
SOUTH ORANGE GYNECOLOGY PC
Practice address
600 Route 208
Monroe, NY 10950
Phone
(845) 782-7277
Fax
(845) 782-5745
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Bernard Peter Luck, MD
Title
Owner Physician
Phone
(845) 782-5745

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VG0400X Primary

Addresses

Primary practice location

600 Route 208
Monroe, NY 10950

Mailing address

600 Route 208
Monroe, NY 10950
Phone (845) 782-7277

National Provider Directory

National Provider Directory

Locations

600 State Route 208
Monroe, NY 10950
Phone (845) 782-7277

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254182400000",
    "number": "1003907072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 ROUTE 208",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "10950",
            "telephone_number": "845-782-7277",
            "fax_number": "845-782-5745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ROUTE 208",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "10950",
            "telephone_number": "845-782-7277",
            "fax_number": "845-782-5745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ORANGE GYNECOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2009-09-29",
        "status": "A",
        "authorized_official_last_name": "LUCK",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "845-782-5745",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.