Provider Demographics
NPI:1740458454
Name:MYLES S KOBREN, MD, PC
Entity type:Organization
Organization Name:MYLES S KOBREN, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TARAYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHURMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-933-8527
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1744861174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty