MEDICARE: JERRY LUBLINER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	148998	NY

General Provider Information

NPI Number	:	1194816876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JERRY LUBLINER MD

Provider Business Mailing Address
First Line	:	215 E 73RD ST
Second Line	:	SUITE 3C
City	:	NEW YORK
State	:	NY
Zip	:	10021-3653
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 E 73RD ST
Second Line	:	SUITE 3C
City	:	NEW YORK
State	:	NY
Zip	:	10021-3653
Country	:	US
Telephone Number	:	212-249-8200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	12/18/2007

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