Provider Demographics
NPI:1790848737
Name:LUBOW, RYNA C (MSW LCSW BCD)
Entity Type:Individual
Prefix:MRS
First Name:RYNA
Middle Name:C
Last Name:LUBOW
Suffix:
Gender:F
Credentials:MSW LCSW BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:784 FRANKLIN AVENUE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417
Mailing Address - Country:US
Mailing Address - Phone:201-848-5578
Mailing Address - Fax:201-848-5599
Practice Address - Street 1:784 FRANKLIN AVENUE
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417
Practice Address - Country:US
Practice Address - Phone:201-848-5578
Practice Address - Fax:201-848-5599
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ445C004518001041C0700X
NYPRO13939-11041C0700X
NJ37FI00075100106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ184912OtherHEALTH NET
NY13015400OtherMAGELLAN
NJP795830OtherOXFORD
NJ13015400OtherMAGELLAN
NJ13015400OtherMAGELLAN
NJ675451Medicare ID - Type Unspecified