Provider Demographics
NPI:1225854706
Name:LUBCZENKO, ERIK (DPT)
Entity type:Individual
Prefix:DR
First Name:ERIK
Middle Name:
Last Name:LUBCZENKO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 STUART ST
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-1134
Mailing Address - Country:US
Mailing Address - Phone:516-784-8787
Mailing Address - Fax:
Practice Address - Street 1:145 STUART ST
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-1134
Practice Address - Country:US
Practice Address - Phone:516-784-8787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-29
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049230225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist