Provider Demographics
NPI:1235759994
Name:LUBKIN, NAOMI E (APN)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:E
Last Name:LUBKIN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 LONGSTONE DR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1989
Mailing Address - Country:US
Mailing Address - Phone:609-320-0055
Mailing Address - Fax:856-751-5668
Practice Address - Street 1:404 LONGSTONE DR
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1989
Practice Address - Country:US
Practice Address - Phone:609-320-0055
Practice Address - Fax:856-751-5668
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN06969000363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner