Individual
DR. JACQUELINE S LUSTGARTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 W 89TH ST, APT 2-M, NEW YORK, NY 10024-1932
(201) 926-9267
Mailing address
100 W 89TH ST, APT 2-M, NEW YORK, NY 10024-1932
(201) 926-9267
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
144616
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
144616
MEDICAL LICENSE
NY
Enumeration date
05/17/2012
Last updated
05/17/2012
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