Provider Demographics
NPI:1467883363
Name:LUSTIG HEALING ARTS LLC
Entity Type:Organization
Organization Name:LUSTIG HEALING ARTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:LUSTIG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-472-5433
Mailing Address - Street 1:2 ARNOT ST
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644-1629
Mailing Address - Country:US
Mailing Address - Phone:973-472-5433
Mailing Address - Fax:973-473-6833
Practice Address - Street 1:2 ARNOT ST
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:NJ
Practice Address - Zip Code:07644-1629
Practice Address - Country:US
Practice Address - Phone:973-472-5433
Practice Address - Fax:973-473-6833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00615900111N00000X
NJ38MC00316500111NN1001X
NJ25MZ00074700171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty