Provider Demographics
NPI:1801662762
Name:LUSTERINO, VERONICA
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:LUSTERINO
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 1:875 CATALPA DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-4026
Mailing Address - Country:US
Mailing Address - Phone:516-507-4453
Mailing Address - Fax:
Practice Address - Street 1:3250 WESTCHESTER AVE STE 202
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-4580
Practice Address - Country:US
Practice Address - Phone:347-621-2184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst