Provider Demographics
NPI:1760461768
Name:KOLBOVSKY, IOSIF (MD)
Entity Type:Individual
Prefix:DR
First Name:IOSIF
Middle Name:
Last Name:KOLBOVSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 WESTCHESTER AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2901
Mailing Address - Country:US
Mailing Address - Phone:914-681-3146
Mailing Address - Fax:914-682-6403
Practice Address - Street 1:222 WESTCHESTER AVE
Practice Address - Street 2:SUITE 405
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-2906
Practice Address - Country:US
Practice Address - Phone:914-683-6474
Practice Address - Fax:914-682-6403
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY455919-1207RN0300X
CT042936207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY133884168OtherPHCS
NY0005947624OtherAETNA (NON HMO)
NY173AU1/173AU2OtherBLUE CROSS ALL PLANS
NY3399522OtherGHI PPO
NYP670485OtherOXFORD
NY1829646OtherUNITED HEALTH CARE
NY01695629/0233897Medicaid
NY133884168OtherEMPIR STATE PLAN (NYS)
NY133884168OtherPOMCO
NY000000077243OtherGHI HMO
NY0D2976OtherHEALTH NET
NY133884168OtherBEECH STREET
NY133884168OtherCIGNA SPECIALTY
NY133884168OtherHIP
NY133884168OtherMULTIPLAN
NY3375645OtherAENTAN HMO
NY002989OtherCONNECTICARE
NY133884168OtherHORIZON HEALTHCARE OF NY
NY133884168OtherPHCS
NY3399522OtherGHI PPO