Provider Demographics
NPI:1952459091
Name:LUBLIN, VICTORIA BEECH (PHD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:BEECH
Last Name:LUBLIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 AVALON RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-3901
Mailing Address - Country:US
Mailing Address - Phone:516-466-1090
Mailing Address - Fax:516-466-1090
Practice Address - Street 1:3 E 68TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4903
Practice Address - Country:US
Practice Address - Phone:212-628-9200
Practice Address - Fax:212-472-7253
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007800-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV66531Medicare ID - Type Unspecified