Provider Demographics
NPI:1649455940
Name:KILBERG, PAMELA CATHER (LAC)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:CATHER
Last Name:KILBERG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:498 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-2506
Mailing Address - Country:US
Mailing Address - Phone:718-643-9689
Mailing Address - Fax:
Practice Address - Street 1:498 WARREN ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-2506
Practice Address - Country:US
Practice Address - Phone:718-643-9689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002488171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist