Individual
LOIS EILEEN BRUSTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 10TH AVE STE 11A, PERINATAL ASSOCIATES OF SLR, NEW YORK, NY 10019-1147
(212) 523-8110
(212) 523-3472
Mailing address
PO BOX 95000-4930, PERINATAL ASSOCIATES OF SLR, PHILADELPHIA, PA 19195-4930
(516) 338-5300
(516) 333-1075
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
149044-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01042066
—
NY
01
—
10457394
CAQH ID
—
01
—
149044-1
NYS LICENSE
NY
Enumeration date
08/09/2005
Last updated
03/07/2023
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