Individual
LORNA JAYNE CLARK-RUBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11 HAMMOND LN, STE A, PLATTSBURGH, NY 12901-2003
(518) 561-0063
(518) 561-0947
Mailing address
11 HAMMOND LN, STE A, PLATTSBURGH, NY 12901-2003
(518) 561-0063
(518) 561-0947
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
183078-1
NY
2084P0804X
Child & Adolescent Psychiatry Physician
183078-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000490037001
BLUESHIELD OF NORTHEASTERN NY
NY
05
—
01201207
—
NY
01
—
137849
VALUEOPTIONS
NY
01
—
209121
MVP
NY
01
—
3194595
GHI
—
Enumeration date
07/27/2005
Last updated
07/01/2010
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