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General NPI Number Information
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NPI Number | 1932149788
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Entity Type | Organization
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Legal Business Name | RONALD S LUBETSKY MD
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 03/07/2008
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Provider Practice Location Address
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Address Line | 18648 NW 67TH AVE
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City | HIALEAH
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State | FL
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Zip | 33015-2406
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Country | US
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Telephone | 305-622-3434
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Fax | 305-622-9429
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Provider Business Mailing Address
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Address Line | 193 FOX HOLLOW RD
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City | WYCKOFF
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State | NJ
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Zip | 07481-2514
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAUL TAMBERELLI
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Credential |
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Telephone | 201-831-0103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 5895744
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License Number State | FL
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