Provider Demographics
NPI:1265717029
Name:KUBICINA, KAREN (PT, DPT, OCS, ATC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:KUBICINA
Suffix:
Gender:F
Credentials:PT, DPT, OCS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 W 24TH ST
Mailing Address - Street 2:FLOOR 7
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-1911
Mailing Address - Country:US
Mailing Address - Phone:212-997-7490
Mailing Address - Fax:212-997-7492
Practice Address - Street 1:147 W 24TH ST
Practice Address - Street 2:FLOOR 7
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-1911
Practice Address - Country:US
Practice Address - Phone:212-997-7490
Practice Address - Fax:212-997-7492
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2017-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033918225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist