Provider Demographics
NPI:1992090591
Name:LUSK-CACERES, CHRISTINA (DO)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:LUSK-CACERES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:776 SHREWSBURY AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-4507
Mailing Address - Country:US
Mailing Address - Phone:732-530-4949
Mailing Address - Fax:732-530-3618
Practice Address - Street 1:776 SHREWSBURY AVE
Practice Address - Street 2:STE 201
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-4507
Practice Address - Country:US
Practice Address - Phone:732-530-4949
Practice Address - Fax:732-530-3618
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB09562600207QS0010X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine