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Contact Information

MARK J KULBASKI, MD
1 PEARL ST
SUITE 2000
BROCKTON, MA02301
 Phone: 508-584-4104
 Fax: 508-584-4105
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vascular Surgery

2086S0129X 76 Physician/Peripheral Vascular Disease
Indicates primary specialty

NPI Profile & details for MARK J KULBASKI · (Male)

NPI # 1699756247
Status Active
Credentials MD
Entity Individual
Enumeration date 11/10/2005
Last updated 03/11/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • MA License # 78343
  • MA Medicaid 110149524A
Hospital affiliation(s)
  • GOOD SAMARITAN MEDICAL CENTER - (Acute Care)
    235 NORTH PEARL STREET
    BROCKTON, MA 02301
  • ST ELIZABETH'S MEDICAL CENTER - (Acute Care)
    736 CAMBRIDGE STREET
    BRIGHTON, MA 02135
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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