Healthcare Provider Details

I. General information

NPI: 1598781833
Provider Name (Legal Business Name): GAIL M KUBRIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 11/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STATE ROUTE 1014 TORRANCE STATE HOSPITAL
TORRANCE PA
15779
US

IV. Provider business mailing address

121 S LANG AVE
PITTSBURGH PA
15208-2745
US

V. Phone/Fax

Practice location:
  • Phone: 724-459-4446
  • Fax: 724-459-4477
Mailing address:
  • Phone: 724-459-4446
  • Fax: 724-459-4477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD030433E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: