Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 148998 | NY |
NPI | 1194816876 |
---|---|
Provider Name | Jerry Lubliner |
First Address | New York, NY 10021-3653 |
Second Address | New York, NY 10021-3653 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 18/12/2007 |