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Individual

DR. PAUL ALAN LUSMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
120 N COUNTRY RD, SUITE 1, PORT JEFFERSON, NY 11777-2604
(631) 928-4990
Mailing address
120 N COUNTRY RD, SUITE 1, PORT JEFFERSON, NY 11777-2604
(631) 928-4990

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
096648-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00393366
NY
Enumeration date
07/12/2005
Last updated
07/08/2007
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