Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 36-00-2220-L | OH |
Y | 222Z00000X | Podiatrist | 36-00-2220-L | OH |
N | 213ES0131X | Foot Surgery | 36-00-2220-L | OH |
NPI | 1063401727 |
---|---|
Provider Name | Jeffrey D Lubell |
First Address | Euclid, OH 44123-2032 |
Second Address | Euclid, OH 44123-2032 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2005 |
Last Update Date | 23/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0592943 | (05) | OH |
T80745 | (02) | OH |