Lustgarten, Marcie

Lustgarten, Marcie is an sole proprietor health care provider with primary practice located at 747 Boston Post Rd , Madison CT 06443-3044. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Lustgarten, Marcie can be contacted via phone (203) 245-1492.

Contact Information

Primary practice address
747 Boston Post Rd Madison CT 06443-3044
Phone: (203) 245-1492
Fax: (203) 245-9002
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 002226 Connecticut

Profile Details

NPI number 1134190887
LBN Legal business name Lustgarten, Marcie
Credentials OD LLC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 31st, 2006
Last updated Feb 9th, 2022 - about 4 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 1134190887 NPPES
Other 061310883 AETNA
Other 84069 AETNA
Other CT02226 AETNA
Other 061310883 AETNA
Other 061310883 AETNA
Other 117603 AETNA
Other 117603 AETNA
Other 906172 AETNA
Other P00125652 AETNA
Other 061310883 AETNA
Other 061310883 AETNA
Other 061310883 AETNA
Other 610883 AETNA
Other P377925 AETNA
Other 061310883 AETNA
Other OVO248 AETNA
MEDICAID 004105575 AETNA
Other 090002226CT01 AETNA

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