Lusomed LLC
Clinic/Center, Medical Specialty in Brooklyn, NY. Organization (NPI-2).
NPI number1104778638
StatusActive
Last updated in NPPESFeb 9, 2026
Details
- NPI
- 1104778638
- Entity type
- Organization (NPI-2)
- Legal business name
- Lusomed LLC
- Organization subpart
- No
- Enumeration date
- Feb 9, 2026
- Certification date
- Feb 9, 2026
- Last updated
- Feb 9, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM2500X | Clinic/Center, Medical Specialty | – | – | Yes |
Practice location
2635 E 24th St Apt 1Brooklyn, NY 11235-2698
Phone 347-733-3709
Mailing address
2635 E 24th St Apt 1Brooklyn, NY 11235-2698
Authorized official
Ketevani Shavliashvili
Founder & Ceo
3477333709
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