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Individual

SHANI KORNBLUTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
22121 JAMAICA AVE, QUEENS VILLAGE, NY 11428-2015
(718) 530-0374
Mailing address
1448 E 19TH ST, BROOKLYN, NY 11230-6716
(718) 683-4420

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
722397
NY

Other

Enumeration date
11/17/2016
Last updated
11/17/2016
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