Healthcare Provider Details
I. General information
NPI: 1386832210
Provider Name (Legal Business Name): CHRISTIANE LYNN KUBIT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/04/2007
Last Update Date: 07/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
24 HOSPITAL AVE
DANBURY CT
06810-6099
US
IV. Provider business mailing address
24 HOSPITAL AVE
DANBURY CT
06810-6099
US
V. Phone/Fax
- Phone: 203-739-6980
- Fax: 203-739-8959
- Phone: 203-739-6980
- Fax: 203-739-8959
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 048579 |
| License Number State | CT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 263480 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: