Healthcare Provider Details

I. General information

NPI: 1194877571
Provider Name (Legal Business Name): KATHLEEN LUBARSKY OTR,L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MANCHESTER DR
BASKING RIDGE NJ
07920-1209
US

IV. Provider business mailing address

50 MANCHESTER DR
BASKING RIDGE NJ
07920-1209
US

V. Phone/Fax

Practice location:
  • Phone: 908-953-0021
  • Fax:
Mailing address:
  • Phone: 908-953-0021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number46TR00316800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: