Provider Demographics
NPI:1114137387
Name:STEVEN KUBERSKY MD PC
Entity Type:Organization
Organization Name:STEVEN KUBERSKY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR CODING
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN CCSP
Authorized Official - Phone:845-634-6500
Mailing Address - Street 1:495 CENTRAL PARK AVE
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1068
Mailing Address - Country:US
Mailing Address - Phone:845-634-6500
Mailing Address - Fax:845-634-9424
Practice Address - Street 1:495 CENTRAL PARK AVE
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1068
Practice Address - Country:US
Practice Address - Phone:845-634-6500
Practice Address - Fax:845-634-9424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179564207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEM691Medicare ID - Type Unspecified