Provider Demographics
NPI:1598585432
Name:SMITH, LUKE OLIVERO (RDN, PHD)
Entity type:Individual
Prefix:DR
First Name:LUKE
Middle Name:OLIVERO
Last Name:SMITH
Suffix:
Gender:M
Credentials:RDN, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 HICKORY TAVERN RD
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:07933-1307
Mailing Address - Country:US
Mailing Address - Phone:908-787-3590
Mailing Address - Fax:
Practice Address - Street 1:120 HICKORY TAVERN RD
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:NJ
Practice Address - Zip Code:07933-1307
Practice Address - Country:US
Practice Address - Phone:908-787-3590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered