Provider Demographics
NPI:1457656753
Name:HOWARD S LUBIN DO LLC
Entity Type:Organization
Organization Name:HOWARD S LUBIN DO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:LUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-789-4464
Mailing Address - Street 1:100 S EAGLE RD
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-3202
Mailing Address - Country:US
Mailing Address - Phone:610-789-4464
Mailing Address - Fax:610-789-7421
Practice Address - Street 1:100 S EAGLE RD
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-3202
Practice Address - Country:US
Practice Address - Phone:610-789-4464
Practice Address - Fax:610-789-7421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS00047OL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty