Provider Demographics
NPI:1336481852
Name:LUBIN, JANE ROBERTA (MD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:ROBERTA
Last Name:LUBIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 EDGE HILL LN
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-3119
Mailing Address - Country:US
Mailing Address - Phone:203-222-9321
Mailing Address - Fax:
Practice Address - Street 1:11 EDGE HILL LN
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-3119
Practice Address - Country:US
Practice Address - Phone:203-222-9321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-22
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT038226207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology