Active NPI
Debra Lyn Lubben, OTR
- Occupational Therapist
- Lake Grove, NY
National Provider Identifier
1366570756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 006400
- Practice address
- 51 Sycamore Ave
Lake Grove, NY 11755-2734 - Phone
- (631) 580-0659
- Fax
- (631) 580-0659
- NPI assigned
- Feb 28, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 006400 | NY | Primary |
Addresses
Primary practice location
51 Sycamore Ave
Lake Grove, NY 11755-2734
Mailing address
51 Sycamore Avenue
Lake Grove, NY 11755
Phone (631) 580-0659
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366570756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 SYCAMORE AVENUE",
"city": "LAKE GROVE",
"state": "NY",
"postal_code": "11755",
"telephone_number": "631-580-0659",
"fax_number": "631-580-0659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 SYCAMORE AVE",
"city": "LAKE GROVE",
"state": "NY",
"postal_code": "117552734",
"telephone_number": "631-580-0659",
"fax_number": "631-580-0659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUBBEN",
"first_name": "DEBRA",
"middle_name": "LYN",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "006400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Grove, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.