Individual
LISSETTE LUGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 CLARA MAASS DR, BELLEVILLE, NJ 07109-3550
(212) 302-4399
(212) 302-2582
Mailing address
1375 BROADWAY, SUITE 506, NEW YORK, NY 10018-7001
(212) 302-4399
(212) 302-2582
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
224552-1
NY
207L00000X
Anesthesiology Physician
Primary
25MA07961400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0088064
—
NJ
05
—
02694668
—
NY
01
—
221948732001
TRICARE
NJ
Enumeration date
01/16/2006
Last updated
11/07/2023
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