Individual
DR. ERIC STEVEN LUSTIG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
4715 PINE ST, PHILADELPHIA, PA 19143-1831
(215) 471-0433
(215) 471-0430
Mailing address
6836 ROOSEVELT BLVD, PHILADELPHIA, PA 19149-2411
(214) 471-0433
(215) 471-0430
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC002614L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LU1436109
PA. BLUE SHIELD
PA
Enumeration date
07/05/2005
Last updated
07/09/2007
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