Provider Demographics
NPI:1639293608
Name:KABUL, VALERIE CINCO (RPA-C)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:CINCO
Last Name:KABUL
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:72 LOVELL AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-4969
Mailing Address - Country:US
Mailing Address - Phone:718-983-0546
Mailing Address - Fax:718-982-0210
Practice Address - Street 1:7554 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-2639
Practice Address - Country:US
Practice Address - Phone:718-326-0400
Practice Address - Fax:718-326-0285
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY010823363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant