Individual
DR. JEFFREY ALAN KOBAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
241 NORTH RD, POUGHKEEPSIE, NY 12601-1154
(845) 471-5519
(845) 471-2928
Mailing address
85 RAYMOND AVE, 104, POUGHKEEPSIE, NY 12603-3117
(845) 471-5519
(845) 471-2928
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
242709
NY
2085R0204X
Vascular & Interventional Radiology Physician
Primary
242709
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03052384
—
NY
Enumeration date
04/21/2008
Last updated
05/09/2012
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