Individual
KATERYNA SHUBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
234 E 149TH ST RM 7-42, BRONX, NY 10451-5504
(718) 579-5900
Mailing address
6495 BROADWAY APT 4N, BRONX, NY 10471-2708
(917) 402-0791
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
020584
NY
363AS0400X
Surgical Physician Assistant
Primary
020584
NY
Other
Enumeration date
02/01/2017
Last updated
02/01/2017
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