Individual
DR. JEFFREY KORNREICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
566 BROADWAY, MASSAPEQUA, NY 11758
(516) 797-8211
(516) 541-0011
Mailing address
25 RIDGE DR E, GREAT NECK, NY 11021
(516) 797-8211
(516) 541-0011
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
194593
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01749962
—
NY
Enumeration date
11/30/2006
Last updated
11/13/2009
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