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General NPI Number Information
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NPI Number | 1528136405
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Entity Type | Individual
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Provider Name | JUDITH RUTH LUSIC M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 14 N CHATSWORTH AVE APT 5C
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City | LARCHMONT
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State | NY
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Zip | 10538-2105
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Country | US
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Telephone | 914-393-8639
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Fax |
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Provider Business Mailing Address
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Address Line | 14 N CHATSWORTH AVE APT 5C
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City | LARCHMONT
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State | NY
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Zip | 10538-2105
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Country | US
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Telephone | 914-393-8639
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Fax | 914-639-6577
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 157444
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License Number State | NY
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