Provider Demographics
NPI:1205308004
Name:KURBAN, FEBEN (AUD)
Entity type:Individual
Prefix:
First Name:FEBEN
Middle Name:
Last Name:KURBAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 SOUTH HOWELL AVENUE
Mailing Address - Street 2:SUITE M
Mailing Address - City:CENTEREACH
Mailing Address - State:NY
Mailing Address - Zip Code:11720
Mailing Address - Country:US
Mailing Address - Phone:917-473-6920
Mailing Address - Fax:917-473-6924
Practice Address - Street 1:625 EAST FORDHAM ROAD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458
Practice Address - Country:US
Practice Address - Phone:917-473-6920
Practice Address - Fax:917-473-6924
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002850231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist