Provider Demographics
NPI:1871511600
Name:SZUBIN, LISA BETH (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:BETH
Last Name:SZUBIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 E 71ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4154
Mailing Address - Country:US
Mailing Address - Phone:212-249-7978
Mailing Address - Fax:212-249-7988
Practice Address - Street 1:3 E 71ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4154
Practice Address - Country:US
Practice Address - Phone:212-249-7978
Practice Address - Fax:212-249-7988
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY195746207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P947066OtherOXFORD
042522OtherBCBS
1040500OtherAETUE
G663533Medicare UPIN
P947066OtherOXFORD