Provider Demographics
NPI:1508911520
Name:COBLENTZ, JAY MORRIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:MORRIS
Last Name:COBLENTZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:150 PURCHASE STREET
Mailing Address - Street 2:STE 2
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-2142
Mailing Address - Country:US
Mailing Address - Phone:914-967-7890
Mailing Address - Fax:914-962-7893
Practice Address - Street 1:150 PURCHASE STREET
Practice Address - Street 2:STE 2
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-2142
Practice Address - Country:US
Practice Address - Phone:914-967-7890
Practice Address - Fax:914-962-7893
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY1090682084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY840461Medicare ID - Type Unspecified
B19610Medicare UPIN