Individual
DR. REBECCA S. KORNBLATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
10 LANGLEY RD, SUITE 200, NEWTON, MA 02459-1972
(617) 615-6525
Mailing address
10 LANGLEY RD, SUITE 200, NEWTON, MA 02459-1972
(617) 615-6525
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
017233-1
NY
103TC0700X
Clinical Psychologist
Primary
9176
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015725
MEDICARE PTAN
MA
Enumeration date
09/27/2007
Last updated
01/18/2012
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