Lustbader, Robert

Lustbader, Robert is an individual health care provider with primary practice located at 425 Robinson Avenue , Newburgh NY 12550. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Lustbader, Robert can be contacted via phone (845) 561-2213.

Contact Information

Primary practice address
425 Robinson Avenue Newburgh NY 12550
Phone: (845) 561-2213
Fax: (845) 561-2411
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 33740 New York

Profile Details

NPI number 1538266150
LBN Legal business name Lustbader, Robert
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 17th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538266150 NPPES
Other 783652 TRICARE UNITED CONCORDIA
MEDICAID 0078878 TRICARE UNITED CONCORDIA

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