Provider Demographics
NPI:1083977573
Name:ERIC, A, LUBIN MD,PC
Entity Type:Organization
Organization Name:ERIC, A, LUBIN MD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SABINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SERBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-462-9159
Mailing Address - Street 1:58 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-2545
Mailing Address - Country:US
Mailing Address - Phone:914-589-1592
Mailing Address - Fax:914-206-4585
Practice Address - Street 1:58 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-2545
Practice Address - Country:US
Practice Address - Phone:914-589-1592
Practice Address - Fax:914-206-4585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162663171R00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No171R00000XOther Service ProvidersInterpreterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10504790Medicare PIN