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General NPI Number Information
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NPI Number | 1285782490
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Entity Type | Organization
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Legal Business Name | JERRY LUBLIN PHD VICTORIA BEECH LUBLIN PHD PSYCH ASSOCIATES PC
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Dates
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Enumeration Date | 01/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3 E 68TH ST
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City | NEW YORK
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State | NY
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Zip | 10021-4903
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Country | US
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Telephone | 212-628-9200
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Fax | 212-472-7253
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Provider Business Mailing Address
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Address Line | 9 AVALON RD
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City | GREAT NECK
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State | NY
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Zip | 11021-3901
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Country | US
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Telephone | 516-466-1090
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Fax | 516-466-1090
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Authorized Official
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Title or Position | PRESIDENT
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Name | VICTORIA BEECH LUBLIN
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Credential | PH.D.
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Telephone | 516-466-1090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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