Individual
FRED KUBUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5904 SHERIDAN DR, WILLIAMSVILLE, NY 14221-5873
(716) 886-5493
(716) 886-5835
Mailing address
5904 SHERIDAN DR, WILLIAMSVILLE, NY 14221-5873
(716) 886-5493
(716) 886-5835
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
020978
NY
363AM0700X
Medical Physician Assistant
020978
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730572140
—
NV
Enumeration date
03/09/2015
Last updated
04/08/2021
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