Individual
DANIEL M KORNBLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
201 E GREEN ST, ITHACA, NY 14850-5635
(607) 274-6230
(607) 274-6316
Mailing address
201 E GREEN ST, ITHACA, NY 14850-5635
(607) 274-6230
(607) 274-6316
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
329943
NY
Other
Enumeration date
12/01/2010
Last updated
12/01/2010
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