Provider Demographics
NPI:1932282092
Name:LUBAS, ANDREW STANLEY (MD)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:STANLEY
Last Name:LUBAS
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 1:379 RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:NORTH ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07031
Mailing Address - Country:US
Mailing Address - Phone:201-246-0200
Mailing Address - Fax:201-246-0668
Practice Address - Street 1:379 RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:NORTH ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07031
Practice Address - Country:US
Practice Address - Phone:201-246-0200
Practice Address - Fax:201-246-0668
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA044486207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LU577503Medicare ID - Type Unspecified
C96284Medicare UPIN