Provider Demographics
NPI:1225216732
Name:LUGO, ERIC R (PSYCHOLOGIST)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:R
Last Name:LUGO
Suffix:
Gender:M
Credentials:PSYCHOLOGIST
Other - Prefix:MR
Other - First Name:ERIC
Other - Middle Name:R
Other - Last Name:LUGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYCHOLOGIST
Mailing Address - Street 1:CASCADA ST 5
Mailing Address - Street 2:MUNOZ RIVERA DEV
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:939-645-0260
Mailing Address - Fax:
Practice Address - Street 1:CASCADA ST 5
Practice Address - Street 2:MUNOZ RIVERA DEV
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:939-645-0260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2867103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling