Individual provider Active NPI

Justine Lukwago, RN

  • Registered Nurse
  • Bronx, NY
National Provider Identifier
1366336067
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
577587 Issued in NY
Practice address
1500 Waters PL
Bronx, NY 10461-2723
Phone
(929) 348-3261
Fax
(929) 348-3269
NPI assigned
Jun 6, 2025
Last updated
Jun 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 577587 NY Primary

Addresses

Primary practice location

1500 Waters PL
Bronx, NY 10461-2723

Mailing address

1500 Waters PL
Bronx, NY 10461-2723
Phone (929) 348-3261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
577587NYMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1749168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1366336067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 WATERS PL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612723",
            "telephone_number": "929-348-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 WATERS PL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612723",
            "telephone_number": "929-348-3261",
            "fax_number": "929-348-3269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKWAGO",
        "first_name": "JUSTINE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-06",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "577587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.