| Richard Kubiak, MD | |
|
54 Woodville Rd, Shoreham, NY 11786-1331 | |
| (631) 929-1256 | |
| (631) 929-8313 |
| Full Name | Richard Kubiak |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Location | 54 Woodville Rd, Shoreham, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326014556 | NPI | - | NPPES |
| 01006688 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 169449 (New York) | Primary |
| Entity Name | Peconic Bay Primary Medical Care |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487620613 PECOS PAC ID: 7113817602 Enrollment ID: O20040318000260 |
| Mailing Address | Practice Location Address |
|---|---|
| Richard Kubiak, MD 185 Old Country Rd, Suite 2, Riverhead, NY 11901-2121 Ph: (631) 298-4479 | Richard Kubiak, MD 54 Woodville Rd, Shoreham, NY 11786-1331 Ph: (631) 929-1256 |
Owen Yen, Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 45 Route 25a, Suite C, Shoreham, NY 11786 Phone: 631-744-3303 | |
Hariton Kousourou, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 45 Route 25a, Suite C, Shoreham, NY 11786 Phone: 631-821-2626 Fax: 631-744-1627 | |
Eric Hoffmann, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 45 Route 25a, Suite C, Shoreham, NY 11786 Phone: 631-744-3303 Fax: 631-744-1627 |