Provider Demographics
NPI:1194693622
Name:PETROSYAN, LUSINE (RN)
Entity type:Individual
Prefix:MISS
First Name:LUSINE
Middle Name:
Last Name:PETROSYAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 LANDVALE RD
Mailing Address - Street 2:
Mailing Address - City:SPOTSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08884-1712
Mailing Address - Country:US
Mailing Address - Phone:646-600-0830
Mailing Address - Fax:
Practice Address - Street 1:39 LANDVALE RD
Practice Address - Street 2:
Practice Address - City:SPOTSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08884-1712
Practice Address - Country:US
Practice Address - Phone:646-600-0830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-27
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR27215400163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse