Individual
CHARLES JONATHAN LUGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-2118
(631) 444-5400
(631) 444-7538
Mailing address
PO BOX 1559, STONY BROOK, NY 11794-8460
(631) 444-5400
(316) 444-7538
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
312752
NY
2085R0202X
Diagnostic Radiology Physician
ME144236
FL
2085R0204X
Vascular & Interventional Radiology Physician
036177510
IL
2085R0204X
Vascular & Interventional Radiology Physician
76554
MN
2085R0204X
Vascular & Interventional Radiology Physician
C3181
KY
Other
Enumeration date
03/29/2014
Last updated
11/14/2025
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