Provider Demographics
NPI:1245467216
Name:LUBLINER, EUGENE P (PSYD)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:P
Last Name:LUBLINER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:565 ROUTE 25A
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-2663
Mailing Address - Country:US
Mailing Address - Phone:631-821-7214
Mailing Address - Fax:631-389-2552
Practice Address - Street 1:565 ROUTE 25A
Practice Address - Street 2:SUITE 201
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-2663
Practice Address - Country:US
Practice Address - Phone:631-821-7214
Practice Address - Fax:631-389-2552
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018670103TC0700X
NY1134904103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool