Provider Demographics
NPI:1104872803
Name:KARLIN, LUBA (MD)
Entity type:Individual
Prefix:DR
First Name:LUBA
Middle Name:
Last Name:KARLIN
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 1:1112 BUCKINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-6316
Mailing Address - Country:US
Mailing Address - Phone:917-842-0705
Mailing Address - Fax:
Practice Address - Street 1:436 FORT WASHINGTON AVE
Practice Address - Street 2:SUITE 1H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-3507
Practice Address - Country:US
Practice Address - Phone:212-781-4720
Practice Address - Fax:212-923-9585
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219013208100000X
NJMA72077208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJI20265Medicare UPIN
NY2177J1Medicare PIN