Provider Demographics
NPI:1821142910
Name:LUSTIG, ROBIN (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:
Last Name:LUSTIG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ARNOT ST
Mailing Address - Street 2:SUITE 3
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:SUITE 3
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
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC03165111N00000X
NJ25MZ00074700171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1821142910OtherINDIVIDUAL NPI
NJP471805OtherOXFORD
NJJ20724OtherHEALTHNET LANDMARK
NJAETNAOther2503663
NJAETNAOther2500826
NJ1851443964OtherGROUP NPI
NJ223774204DOtherBLUE CROSS BLUE SHIELD
NJ585048PNWMedicare PIN
NJAETNAOther2503663