Individual
TODD LUSTIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
360 MONTAUK HWY, WEST ISLIP, NY 11795-4403
(631) 422-1110
(631) 422-1916
Mailing address
33 STUART DR, SYOSSET, NY 11791-5123
(631) 422-1110
(631) 422-1916
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV0056671
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01953011
—
NY
Enumeration date
01/27/2006
Last updated
03/03/2015
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