MEDICARE: DR. ROBERT H LUSTIG D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	25MB03774500	NJ
2	207RG0100X	Gastroenterology Physician	25MB03774500	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457394652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT H LUSTIG D.O.

Provider Business Mailing Address
First Line	:	766 US HIGHWAY 202/206 NORTH
Second Line	:	SUITE 1
City	:	BRIDGEWATER
State	:	NJ
Zip	:	08807-1773
Country	:	US
Telephone Number	:	908-722-0808
Fax Number	:	908-722-7645

Provider Business Practice Location Address
First Line	:	766 US HIGHWAY 202/206 NORTH
Second Line	:	SUITE 1
City	:	BRIDGEWATER
State	:	NJ
Zip	:	08807-1773
Country	:	US
Telephone Number	:	908-722-0808
Fax Number	:	908-722-7645

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	12/07/2017

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Directions to “ DR. ROBERT H LUSTIG D.O.” Practice Location

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