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Individual

DR. JONATHAN KOBLENZER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
16 E 79TH ST, SUITE 42, NEW YORK, NY 10021-0150
(212) 794-7115
(212) 585-2178
Mailing address
16 E 79TH ST, SUITE 42, NEW YORK, NY 10021-0150
(212) 794-7115
(212) 585-2178

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
148833
NY
2084P0805X
Geriatric Psychiatry Physician
Primary
148833
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01127682
NY
Enumeration date
09/06/2006
Last updated
09/11/2025
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