| Doctor Name: | CHRISTIAN JOHN KUBICK |
| NPI Number: | 1124292057 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | D3159 |
| Business Practice Address: | 393 Millburn Ave Millburn, NJ - 070411326 |
| Business Phone Number: | 9734671690 |
| Business Fax Number: | 9732589075 |
| Mailing Address: | 393 Millburn Ave, MILLBURN |
| State: | NJ |
| Postal Code: | 070411326 |
| Phone Number: | 9734671690 |
| Fax Number: | 9732589075 |
| NPI Enumeration Date: | 04/22/2008 |
| NPI Last Update Date: | 04/22/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1101X |
| License Number: | D3159 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Ophthalmic Assistant |
| Taxonomy Definition: | |