# LUSOMED LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104778638
- **Authorized official:** KETEVANI SHAVLIASHVILI NON-US MD DEGREE (FOUNDER & CEO)
- **Authorized official phone:** (347) 733-3709

## Contact information

- **Practice address:** 2635 E 24TH ST APT 1, BROOKLYN, NY 11235-2698
- **Practice address phone:** (347) 733-3709
- **Mailing address:** 2635 E 24TH ST APT 1, BROOKLYN, NY 11235-2698

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/09/2026
- **Last updated:** 02/09/2026