Provider Demographics
NPI:1083988240
Name:LUSTIGER, ARIELLA
Entity Type:Individual
Prefix:
First Name:ARIELLA
Middle Name:
Last Name:LUSTIGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ARIELLA
Other - Middle Name:
Other - Last Name:FRIEDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:24 LAUREL HILL TER
Mailing Address - Street 2:APT 6C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-1611
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1800 ANDREWS AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-5202
Practice Address - Country:US
Practice Address - Phone:718-299-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017230225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist