Provider Demographics
NPI:1356393276
Name:WOROCH, LUBOMYR (MD)
Entity type:Individual
Prefix:DR
First Name:LUBOMYR
Middle Name:
Last Name:WOROCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-2996
Mailing Address - Country:US
Mailing Address - Phone:914-965-7271
Mailing Address - Fax:
Practice Address - Street 1:131 PARK AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-2996
Practice Address - Country:US
Practice Address - Phone:914-965-7271
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142088208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB14239Medicare UPIN
NY40A411Medicare ID - Type Unspecified