Provider Demographics
NPI:1760024319
Name:LUSCHWITZ, LINDSAY ANNE
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ANNE
Last Name:LUSCHWITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3408 BRIARCLIFF DR APT T
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-5170
Mailing Address - Country:US
Mailing Address - Phone:845-389-1527
Mailing Address - Fax:
Practice Address - Street 1:2610 STANTONSBURG RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2800
Practice Address - Country:US
Practice Address - Phone:252-847-9908
Practice Address - Fax:252-847-0819
Is Sole Proprietor?:No
Enumeration Date:2019-10-16
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY86053374133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered