Individual
EVETTE KUBICHKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
67 W TACONIC RD, WAPPINGERS FALLS, NY 12590-6632
(845) 380-6311
Mailing address
67 W TACONIC RD, WAPPINGERS FALLS, NY 12590-6632
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
260745
NY
Other
Enumeration date
04/15/2016
Last updated
04/15/2016
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