Individual
MARK J. KULBASKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 PEARL ST, SUITE 2000, BROCKTON, MA 02301
(508) 584-4104
(508) 584-4105
Mailing address
960 MASSACHUSETTS AVENUE, FL 2, BOSTON, MA 02118-2690
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
78343
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110149524A
—
MA
Enumeration date
11/10/2005
Last updated
03/11/2025
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