# DR. JACOB J LUSTGARTEN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1316072598
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0102X | Surgical Critical Care Physician | 0101229914 | VA | — |
| 2086S0129X | Vascular Surgery Physician | D0056700 | MD | — |
| 2086S0129X | Vascular Surgery Physician | D56700 | MD | — |
| 2086S0129X | Vascular Surgery Physician | MD32668 | DC | Yes |

## Other

- **Enumeration date:** 02/21/2007
- **Last updated:** 06/21/2023