Kornblatt, Martin

Kornblatt, Martin is an individual health care provider with primary practice located at 4202 Main St , Flushing NY 11355-3822. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Kornblatt, Martin can be contacted via phone (718) 539-5888.

Contact Information

Primary practice address
4202 Main St Flushing NY 11355-3822
Phone: (718) 539-5888
Fax: (718) 463-2207
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X TUV004300 New York

Profile Details

NPI number 1144215922
LBN Legal business name Kornblatt, Martin
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 16th, 2005
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 1144215922 NPPES
New York MEDICAID 00822977

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