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General NPI Number Information
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NPI Number | 1043396989
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Entity Type | Individual
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Provider Name | KATLYNE LUBIN MD
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Gender | Female
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 1135 BROAD ST
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City | CLIFTON
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State | NJ
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Zip | 07013-3346
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Country | US
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Telephone | 888-244-5373
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Fax | 973-365-3089
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Provider Business Mailing Address
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Address Line | 1135 BROAD ST
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City | CLIFTON
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State | NJ
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Zip | 07013-3346
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Country | US
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Telephone | 888-244-5373
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Fax | 973-365-3089
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | 175186
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | 25MA05750600
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License Number State | NJ
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