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Individual
DR. LUCKY LUSTERIO
Active
Individual
DR. LUCKY LUSTERIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
02004069A
IN
208D00000X
General Practice Physician
Primary
02004069A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02004069A
MEDICAL LICENSE
IN
Enumeration date
02/21/2012
Last updated
10/10/2025
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