Healthcare Provider Details

I. General information

NPI: 1972689818
Provider Name (Legal Business Name): PAUL JUBINSKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 10/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 BRADHURST AVE
HAWTHORNE NY
10532
US

IV. Provider business mailing address

19 BRADHURST AVE
HAWTHORNE NY
10532
US

V. Phone/Fax

Practice location:
  • Phone: 914-493-7997
  • Fax: 914-594-4022
Mailing address:
  • Phone: 914-493-7997
  • Fax: 914-594-4022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number174194
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: