Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | 139630 | NY |
Y | 207VX0201X | Gynecologic Oncologist | 139630 | NY |
NPI | 1144480427 |
---|---|
Provider Name | Stephane S Lubicz |
First Address | Bronx, NY 10463-1409 |
Second Address | Bronx, NY 10463-1409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2008 |
Last Update Date | 11/06/2008 |