Provider Demographics
NPI:1417165523
Name:LUBARSKY, DIANE JOAN (DIANE LUBARSKY OTR)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:JOAN
Last Name:LUBARSKY
Suffix:
Gender:F
Credentials:DIANE LUBARSKY OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 OCEAN PKWY
Mailing Address - Street 2:APARTMENT D6
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-2461
Mailing Address - Country:US
Mailing Address - Phone:718-972-4886
Mailing Address - Fax:
Practice Address - Street 1:44 LEE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-7216
Practice Address - Country:US
Practice Address - Phone:718-963-0882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009004-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQS967Q4AC1Medicare PIN