MEDICARE: DR. MICHAEL DUBIN M.D.

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	207R00000X	Internal Medicine Physician	208056	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1346333564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL DUBIN M.D.

Provider Business Mailing Address
First Line	:	1351 ROUTE 55 STE 200
Second Line	:
City	:	LAGRANGEVILLE
State	:	NY
Zip	:	12540-5128
Country	:	US
Telephone Number	:	845-475-9661
Fax Number	:	845-475-9938

Provider Business Practice Location Address
First Line	:	150 ROUTE 52
Second Line	:
City	:	CARMEL
State	:	NY
Zip	:	10512-1200
Country	:	US
Telephone Number	:	845-228-2910
Fax Number	:	845-228-2914

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	12/07/2017

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