Individual
DR. JACQUELINE O LUSTIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
380 MAIN ST, WATERTOWN, CT 06795-2260
(860) 274-8891
(860) 274-8895
Mailing address
380 MAIN ST, WATERTOWN, CT 06795-2260
(860) 274-8891
(860) 274-8895
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
041948
CT
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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