Individual
MR. BENJAMIN J KORNBLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
302 W SENECA ST, ITHACA, NY 14850-4130
(607) 697-0360
Mailing address
302 W SENECA ST, ITHACA, NY 14850-4130
(607) 697-0360
(607) 272-0240
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
346283
NY
Other
Enumeration date
05/08/2020
Last updated
07/30/2020
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