Provider Demographics
NPI:1508641549
Name:KUBIAK, ABBIGAIL (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:ABBIGAIL
Middle Name:
Last Name:KUBIAK
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1164
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-8164
Mailing Address - Country:US
Mailing Address - Phone:716-348-0937
Mailing Address - Fax:
Practice Address - Street 1:6340 NEWTON RD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-3639
Practice Address - Country:US
Practice Address - Phone:716-348-0937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027224225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist