Provider Demographics
NPI:1235404534
Name:CYBULARZ, PAUL A (LAC, LOM)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:CYBULARZ
Suffix:
Gender:M
Credentials:LAC, LOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 FLOUR LN
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1530
Mailing Address - Country:US
Mailing Address - Phone:267-393-1528
Mailing Address - Fax:
Practice Address - Street 1:333 FLOUR LN
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1530
Practice Address - Country:US
Practice Address - Phone:267-393-1528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOM000123171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist