NPIMap

Organization Active NPI

Dr. Lustgarten

  • Chiropractor
  • Madison, CT
National Provider Identifier
1578736120
Registry record updated Apr 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
476 Issued in CT
Legal business name
DR. LUSTGARTEN
Practice address
15 Meigs Ave
Madison, CT 06443-3057
Phone
(203) 245-8217
NPI assigned
Apr 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2008

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

Authorized official

Name
Dr. Eugene Jay Lustgarten, DCNPI 1669585691
Title
Owner
Phone
(203) 245-8217

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 476 CT Primary

Addresses

Primary practice location

15 Meigs Ave
Madison, CT 06443-3057

Mailing address

15 Meigs Ave
Madison, CT 06443-3057
Phone (203) 245-8217

Other identifiers 1

IdentifierTypeStateIssuer
004095099MedicaidCT

National Provider Directory

National Provider Directory

Locations

15 Meigs Ave
Madison, CT 06443
Phone (203) 245-8217

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207180800000",
    "number": "1578736120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MEIGS AVE",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064433057",
            "telephone_number": "203-245-8217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MEIGS AVE",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064433057",
            "telephone_number": "203-245-8217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. LUSTGARTEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-03",
        "last_updated": "2008-04-03",
        "status": "A",
        "authorized_official_last_name": "LUSTGARTEN",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-245-8217",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004095099",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; 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.