Provider Demographics
NPI:1104114453
Name:KUBASHKY, MORRIS J (RPH)
Entity type:Individual
Prefix:MR
First Name:MORRIS
Middle Name:J
Last Name:KUBASHKY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-1442
Mailing Address - Country:US
Mailing Address - Phone:516-681-6629
Mailing Address - Fax:
Practice Address - Street 1:181 AMSTERDAM AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-5029
Practice Address - Country:US
Practice Address - Phone:212-877-6390
Practice Address - Fax:212-877-6706
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034796183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist