Provider Demographics
NPI:1740366541
Name:KOBREN, MYLES S (MD)
Entity type:Individual
Prefix:
First Name:MYLES
Middle Name:S
Last Name:KOBREN
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 1:400 S OYSTER BAY RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-3500
Mailing Address - Country:US
Mailing Address - Phone:516-933-8527
Mailing Address - Fax:516-933-3838
Practice Address - Street 1:400 S OYSTER BAY RD
Practice Address - Street 2:SUITE 301
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3500
Practice Address - Country:US
Practice Address - Phone:516-933-8527
Practice Address - Fax:516-933-3838
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1744861207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology