Individual
SHIRLEY COBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1841 BRENTWOOD RD, BRENTWOOD, NY 11717-4625
(631) 853-2762
Mailing address
1841 BRENTWOOD RD, BRENTWOOD, NY 11717-4625
(631) 853-2762
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
01/19/2007
Last updated
07/08/2007
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