Organization
IWC SERVICES VIRGINIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE LUSAS MD (OWNER)
(732) 451-4318
Entity
Organization
Contact information
Practice address
301 VILLAGE CIR, BRISTOL, VA 24201-8302
(732) 451-4318
Mailing address
492C CEDAR LN STE 514, TEANECK, NJ 07666-1713
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
04/23/2026
Last updated
04/28/2026
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