Koblenzer, Jonathan

Koblenzer, Jonathan is an sole proprietor health care provider with primary practice located at 16 E 79Th St Suite 42, New York NY 10021-0150. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Geriatric Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Koblenzer, Jonathan can be contacted via phone (212) 794-7115.

Contact Information

Primary practice address
16 E 79Th St Suite 42 New York NY 10021-0150
Fax: (212) 585-2178
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 148833 New York
Allopathic & Osteopathic Physicians / Geriatric Psychiatry 2084P0805X 148833 New York

Profile Details

NPI number 1073616199
LBN Legal business name Koblenzer, Jonathan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 6th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073616199 NPPES
New York MEDICAID 01127682

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