Provider Demographics
NPI:1265763833
Name:KUBIS, NATASHA LEAHI (LAC)
Entity type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:LEAHI
Last Name:KUBIS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 237
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-0004
Mailing Address - Country:US
Mailing Address - Phone:917-576-9198
Mailing Address - Fax:
Practice Address - Street 1:163 REMSEN ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4334
Practice Address - Country:US
Practice Address - Phone:917-576-9198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-21
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004168171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist