Provider Demographics
NPI:1972757722
Name:LUBIN, MEGAN E (DPM)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:E
Last Name:LUBIN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:E
Other - Last Name:LYNAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:54 BEY LEA RD STE 1
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2978
Mailing Address - Country:US
Mailing Address - Phone:732-505-4500
Mailing Address - Fax:732-505-9787
Practice Address - Street 1:54 BEY LEA RD STE 1
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2978
Practice Address - Country:US
Practice Address - Phone:732-505-4500
Practice Address - Fax:732-505-9787
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00310400213ES0103X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ297194Medicaid
228503Medicare PIN