Provider Demographics
NPI:1598781833
Name:KUBRIN, GAIL M (MD)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:M
Last Name:KUBRIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 S LANG AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208-2745
Mailing Address - Country:US
Mailing Address - Phone:724-459-4446
Mailing Address - Fax:724-459-4477
Practice Address - Street 1:STATE ROUTE 1014
Practice Address - Street 2:TORRANCE STATE HOSPITAL
Practice Address - City:TORRANCE
Practice Address - State:PA
Practice Address - Zip Code:15779
Practice Address - Country:US
Practice Address - Phone:724-459-4446
Practice Address - Fax:724-459-4477
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD030433E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01711348Medicaid
PA186878OtherVALUE OPTIONS
PA564101OtherHIGHMARK
PA564101OtherMAGELLAN
PA564101OtherHIGHMARK
564101Medicare ID - Type Unspecified