Provider Demographics
NPI:1720033012
Name:LUBIN, FRANTZ HERNOULD (MD)
Entity Type:Individual
Prefix:
First Name:FRANTZ
Middle Name:HERNOULD
Last Name:LUBIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-6621
Mailing Address - Country:US
Mailing Address - Phone:516-316-9025
Mailing Address - Fax:718-236-8456
Practice Address - Street 1:7 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-1264
Practice Address - Country:US
Practice Address - Phone:516-316-9025
Practice Address - Fax:631-367-0268
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2024-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY19542312084P0800X
NY1954232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY016477726Medicaid
NY09M311Medicare ID - Type Unspecified
NY016477726Medicaid