Provider Demographics
NPI:1699939942
Name:KUBIAK, BRIAN DANIEL (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:DANIEL
Last Name:KUBIAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 LINDEN OAKS STE 310
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2814
Mailing Address - Country:US
Mailing Address - Phone:585-922-5840
Mailing Address - Fax:585-586-7558
Practice Address - Street 1:360 LINDEN OAKS STE 310
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2814
Practice Address - Country:US
Practice Address - Phone:585-922-5840
Practice Address - Fax:585-586-7558
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY250974208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery