Individual
JASON KORNRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
NASSAU UNIVERSITY MEDICAL CENTER, 2201 HEMPSTEAD TURNPIKE, EAST MEADOW, NY 11554
(516) 572-6511
(516) 572-3210
Mailing address
39 RHODES ST, NEW HYDE PARK, NY 11040-1645
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
012559
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012559
LICENSE NUMBER
NY
Enumeration date
10/26/2006
Last updated
07/08/2007
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