Provider Demographics
NPI:1700257235
Name:NEIL KOBROSKY MD
Entity Type:Organization
Organization Name:NEIL KOBROSKY MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:D
Authorized Official - Last Name:KOBROSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-281-6890
Mailing Address - Street 1:85 EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-6512
Mailing Address - Country:US
Mailing Address - Phone:978-281-6890
Mailing Address - Fax:978-281-0932
Practice Address - Street 1:25 HIGHLAND AVE
Practice Address - Street 2:ANNA JAQUES HOSPITAL OUTPATIENT CLINIC
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3867
Practice Address - Country:US
Practice Address - Phone:978-463-1049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty