Provider Demographics
NPI:1467755231
Name:KOBYLSKA, BEATA (RN)
Entity type:Individual
Prefix:
First Name:BEATA
Middle Name:
Last Name:KOBYLSKA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 KEVIN RD
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-2714
Mailing Address - Country:US
Mailing Address - Phone:631-486-4830
Mailing Address - Fax:631-486-4830
Practice Address - Street 1:120 W JOHN ST
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-1020
Practice Address - Country:US
Practice Address - Phone:516-933-0485
Practice Address - Fax:516-933-1923
Is Sole Proprietor?:No
Enumeration Date:2010-12-16
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY631986-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse