Provider Demographics
NPI:1760535546
Name:KUBIT, PAMELA LYNN
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:LYNN
Last Name:KUBIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3372 W 91ST ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-4861
Mailing Address - Country:US
Mailing Address - Phone:216-651-8943
Mailing Address - Fax:440-743-0062
Practice Address - Street 1:6905 RIDGE RD
Practice Address - Street 2:3H
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5648
Practice Address - Country:US
Practice Address - Phone:440-743-0062
Practice Address - Fax:440-743-0062
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2271812163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2271812OtherPERSONAL IDENTIFICATION #