Provider Demographics
NPI:1295988004
Name:KUBRICK, SHARI EVE (MS,OTR/L)
Entity type:Individual
Prefix:
First Name:SHARI
Middle Name:EVE
Last Name:KUBRICK
Suffix:
Gender:F
Credentials:MS,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 NEWCASTLE AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-2719
Mailing Address - Country:US
Mailing Address - Phone:516-939-0638
Mailing Address - Fax:
Practice Address - Street 1:28 NEWCASTLE AVE
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-2719
Practice Address - Country:US
Practice Address - Phone:516-395-1457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0065591225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist