Provider Demographics
NPI:1487922001
Name:KUBOW, FAITH (RN)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:KUBOW
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 1:2910 ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:VALATIE
Mailing Address - State:NY
Mailing Address - Zip Code:12184-5452
Mailing Address - Country:US
Mailing Address - Phone:518-758-6931
Mailing Address - Fax:518-758-2199
Practice Address - Street 1:2910 ROUTE 9
Practice Address - Street 2:
Practice Address - City:VALATIE
Practice Address - State:NY
Practice Address - Zip Code:12184-5452
Practice Address - Country:US
Practice Address - Phone:518-758-6931
Practice Address - Fax:518-758-2199
Is Sole Proprietor?:No
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY512630163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse