Provider Demographics
NPI:1902062607
Name:LUSSIER, JUDITH GRACE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:GRACE
Last Name:LUSSIER
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Gender:F
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:1 BROOKDALE PLAZA
Mailing Address - Street 2:DEPARTMENT OF SURGICAL SERVICES, 185 STRAUSBERG
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213
Mailing Address - Country:US
Mailing Address - Phone:718-240-6400
Mailing Address - Fax:
Practice Address - Street 1:1 BROOKDALE PLZ
Practice Address - Street 2:DEPARTMENT OF SURGICAL SERVICES, 185 STRAUSBERG
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-3139
Practice Address - Country:US
Practice Address - Phone:718-240-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical