Provider Demographics
NPI:1093246050
Name:WERBALOWSKY, KIMBERLY J (RN)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:J
Last Name:WERBALOWSKY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 BREAKEY AVE
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701-2530
Mailing Address - Country:US
Mailing Address - Phone:845-796-3058
Mailing Address - Fax:845-796-3099
Practice Address - Street 1:45 BREAKEY AVE
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-2530
Practice Address - Country:US
Practice Address - Phone:845-796-3058
Practice Address - Fax:845-796-3099
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY686013-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse