Provider Demographics
NPI:1891737318
Name:LYUBARSKY, OKSANA (MD)
Entity Type:Individual
Prefix:
First Name:OKSANA
Middle Name:
Last Name:LYUBARSKY
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 1:2960 RODEO PARK DRIVE WEST
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7507
Mailing Address - Country:US
Mailing Address - Phone:505-986-9633
Mailing Address - Fax:505-820-1209
Practice Address - Street 1:2960 RODEO PARK DR W
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-6351
Practice Address - Country:US
Practice Address - Phone:505-986-9633
Practice Address - Fax:505-820-1209
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2003-00902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM90603061Medicaid
A63789Medicare UPIN
NM90603061Medicaid