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NPI Code Detail

MEDICARE: SPENCER LUBIN MD

MEDICARE: SPENCER LUBIN 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
1207L00000XAnesthesiology Physician179844NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285666420
Entity Type Code : Individual
Provider Name (Legal Business Name) : SPENCER LUBIN MD
Provider Business Mailing Address
First Line : 7 STONYWELL CT
Second Line :
City : DIX HILLS
State : NY
Zip : 11746-5421
Country : US
Telephone Number : 631-462-1736
Fax Number : 631-462-2266
Provider Business Practice Location Address
First Line : 447 ATLANTIC AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11217-1702
Country : US
Telephone Number : 631-462-1736
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 10/19/2015

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