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Individual

DR. CHAYA LIEBA KOBERNICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
13523 78TH RD, FLUSHING, NY 11367-3239
(917) 494-3708
Mailing address
13523 78TH RD, FLUSHING, NY 11367-3239
(917) 494-3708

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
023935
NY
103TC0700X
Clinical Psychologist
P102639
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P102639
NA
NY
05
P102639
NY
Enumeration date
09/20/2019
Last updated
12/07/2020
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