Individual
MRS. KRISTY DYANN LUBAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1534 VICTORY BOULEVARD, STATEN ISLAND, NY 10314
(718) 667-3577
(718) 667-3043
Mailing address
1534 VICTORY BOULEVARD, STATEN ISLAND, NY 10314
(718) 667-3577
(718) 667-3043
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
006234
NY
Other
Enumeration date
03/02/2007
Last updated
05/24/2012
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