Provider Demographics
NPI:1124232541
Name:KOBLENZ-SULCOV, CLAUDIA JOY (PHD)
Entity Type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:JOY
Last Name:KOBLENZ-SULCOV
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CLAUDIA
Other - Middle Name:JOY
Other - Last Name:KOBLENZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:375 MILLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-1100
Mailing Address - Country:US
Mailing Address - Phone:914-242-9324
Mailing Address - Fax:914-242-9324
Practice Address - Street 1:375 MILLWOOD RD
Practice Address - Street 2:
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514-1100
Practice Address - Country:US
Practice Address - Phone:914-242-9324
Practice Address - Fax:914-242-9324
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007014103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist