MEDICARE: CHERYL JILL ATKINS-LUBINSKI

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	156FX1201X	Optometric Assistant Technician

General Provider Information

NPI Number	:	1447702352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL JILL ATKINS-LUBINSKI

Provider Business Mailing Address
First Line	:	154 E LANCASTER AVE
Second Line	:
City	:	WAYNE
State	:	PA
Zip	:	19087-4103
Country	:	US
Telephone Number	:	484-580-8873
Fax Number	:	484-971-0383

Provider Business Practice Location Address
First Line	:	154 E LANCASTER AVE
Second Line	:
City	:	WAYNE
State	:	PA
Zip	:	19087-4103
Country	:	US
Telephone Number	:	484-580-8873
Fax Number	:	484-971-0383

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

Provider Enumeration Date	:	10/26/2016
Last Update Date	:	10/26/2016

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