Jacqueline O Lustig (NPI# 1245246966, PAC ID# 2264441971) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1245246966 |
| PAC ID by PECOS | 2264441971 |
| Professional Enrollment ID | I20060407000228 |
| Full Name | Jacqueline O Lustig |
| Organization Legal Name | TOWN AND COUNTRY PEDIATRICS AND FAMILY MEDICINE, P.C. |
| Address |
205 Columbia Blvd Waterbury CT 06710-1400 |
| Phone Number | 8602748891 |
| Gender | F |
| Credential | DO |
| Medical School | SOUTHEASTERN COLLEGE OF OSTEO MEDICINE |
| Graduation Year | 1993 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 2466461173 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 070005 | WATERBURY HOSPITAL |
| 070016 | SAINT MARYS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 205 Columbia Blvd, Waterbury, CT 06710-1400 | 8602748891 | TOWN AND COUNTRY PEDIATRICS AND FAMILY MEDICINE, P.C. |
| 380 Main St, Watertown, CT 06795-2260 | 8602748891 | TOWN AND COUNTRY PEDIATRICS AND FAMILY MEDICINE, P.C. |
| Organization Legal Name | TOWN AND COUNTRY PEDIATRICS AND FAMILY MEDICINE, P.C. |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melissa Mcintyre | Nurse Practitioner | Town and Country Pediatrics and Family Medicine, P.C. | 380 Main St, Watertown, CT 06795-2260 |
| Ephraim P Bartfeld | Pediatric Medicine | Town and Country Pediatrics and Family Medicine, P.C. | 380 Main St, Watertown, CT 06795-2260 |
| Sabrina Michelle Lachowicz | Physician Assistant | Town and Country Pediatrics and Family Medicine, P.C. | 380 Main St, Watertown, CT 06795-2260 |
| Street Address |
205 COLUMBIA BLVD |
| City | WATERBURY |
| State | CT |
| Zip | 06710-1400 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David Dreyfus | Allergy/immunology | 4 Clifton Ave, Waterbury, CT 06710-1724 | |
| Elisabeth C Archie | Clinical Social Worker | Family Service of Greater Waterbury | 34 Murray St, Waterbury, CT 06710-1997 |
| Esther S Baylis | Clinical Social Worker | Family Service of Greater Waterbury | 34 Murray St, Waterbury, CT 06710-1997 |
| Dorothy K Gaspar | Clinical Social Worker | Family Service of Greater Waterbury | 34 Murray St, Waterbury, CT 06710-1997 |
| City | WATERBURY |
| Zip Code | 06710 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | WATERBURY + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Jacqueline O Lustig.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.