Provider Demographics
NPI:1245370352
Name:LUTZ, JOSEPH SEBASTIAN (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:SEBASTIAN
Last Name:LUTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 S FINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-1418
Mailing Address - Country:US
Mailing Address - Phone:908-766-0339
Mailing Address - Fax:908-204-9192
Practice Address - Street 1:211 S FINLEY AVE
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-1418
Practice Address - Country:US
Practice Address - Phone:908-766-0339
Practice Address - Fax:908-204-9192
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA54591207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE58972Medicare UPIN