Provider Demographics
NPI:1659526085
Name:LUBIN, SOPHIA (DO)
Entity Type:Individual
Prefix:DR
First Name:SOPHIA
Middle Name:
Last Name:LUBIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SOPHIA
Other - Middle Name:
Other - Last Name:LUBIN-LONCKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:94 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-1502
Mailing Address - Country:US
Mailing Address - Phone:718-484-0809
Mailing Address - Fax:
Practice Address - Street 1:350 E 17TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3805
Practice Address - Country:US
Practice Address - Phone:212-420-3901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY39207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology