Provider Demographics
NPI:1144315466
Name:LUSSKIN, SHARI I (MD)
Entity type:Individual
Prefix:DR
First Name:SHARI
Middle Name:I
Last Name:LUSSKIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:161 MADISON AVE
Mailing Address - Street 2:SUITE 10NW
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5421
Mailing Address - Country:US
Mailing Address - Phone:212-779-3660
Mailing Address - Fax:212-696-9411
Practice Address - Street 1:161 MADISON AVE
Practice Address - Street 2:SUITE 10NW
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5421
Practice Address - Country:US
Practice Address - Phone:212-779-3660
Practice Address - Fax:212-696-9411
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2008-04-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1719262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE87298Medicare UPIN