Dr. Eric Steven Lustig
Podiatrist
4715 Pine St
Philadelphia
, Pennsylvania 19143-1831
Dr. Eric Steven Lustig
Podiatrist
4715 Pine St
Philadelphia
, Pennsylvania 19143-1831
(215) 471-0430
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About
Features
Specialties
- Podiatrist
Languages spoken
- English
Location
First Address
- Dr. Eric Steven Lustig
- 6836 Roosevelt Blvd
- Philadelphia, PA
- Zip : 19149-2411
- Fax : (215) 471-0430
- Phone : (214) 471-0433
Second Address
- Dr. Eric Steven Lustig
- 4715 Pine St
- Philadelphia, PA
- Zip : 19143-1831
- Fax : (215) 471-0430
- Phone : (215) 471-0433
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | SC002614L | PA |
| Y | 222Z00000X | Podiatrist | SC002614L | PA |
National Provider Identifier
| NPI | 1063419117 |
|---|---|
| Provider Name | Dr. Eric Steven Lustig |
| First Address | Philadelphia, PA 19149-2411 |
| Second Address | Philadelphia, PA 19143-1831 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/07/2005 |
| Last Update Date | 09/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| LU1436109 | PA. BLUE SHIELD (01) | PA |
| T72709 | (02) | PA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.