Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
EDIE LUSTIG
Active Sole ProprietorEDIE LUSTIG is a Private Vehicle healthcare provider located in GRANGEVILLE, Idaho. NPI 1164988663 is currently active in the NPPES registry. Verify at CMS.
Private Vehicle · GRANGEVILLE, ID
Registration Details
- NPI Number
- 1164988663
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Feb 20, 2019 (7.4902151267667 yrs)
- Last Updated
- Feb 20, 2019
- License
-
WA116016B (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
711 N STATE STGRANGEVILLE, ID, 835301650Browse ID providers · Browse ZIP 83530
- Phone
- 2085072160
- Primary Specialty
-
Private Vehicle
347C00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.