Individual
MS. MAXINE LUBKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, ANP-C
Contact information
Practice address
800 CARTER ST, ROCHESTER, NY 14621-2604
(585) 922-4136
(585) 922-5761
Mailing address
1425 PORTLAND AVE, ROCHESTER, NY 14621-3001
(585) 922-4136
(585) 922-5761
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
303331
NY
363LA2200X
Adult Health Nurse Practitioner
F303331
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01131126/RGH
—
NY
05
—
02699801
—
NY
01
—
G0187459590
EXCELLUS/HMO GROUP NUMBER
NY
01
—
NP0826
PREFERRED CARE PROVIDER N
NY
01
—
P019303331
BC/BS OF ROCHESTER PROVID
NY
Enumeration date
07/13/2006
Last updated
11/14/2019
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