MEDICARE: DR. BRIAN EVAN KUBIT DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC 05886L	PA

General Provider Information

NPI Number	:	1699716811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN EVAN KUBIT DC

Provider Business Mailing Address
First Line	:	125 OLD FARM DR
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15239-2353
Country	:	US
Telephone Number	:	412-798-4114
Fax Number	:

Provider Business Practice Location Address
First Line	:	1014 UNITY CENTER RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15239-1857
Country	:	US
Telephone Number	:	412-704-7710
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	12/12/2007

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