Healthcare Provider Details

I. General information

NPI: 1710864202
Provider Name (Legal Business Name): CARALINE KOBEL
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2341 NEW HYDE PARK RD
NEW HYDE PARK NY
11042-1212
US

IV. Provider business mailing address

1400 OLD COUNTRY RD STE C103N
WESTBURY NY
11590-5156
US

V. Phone/Fax

Practice location:
  • Phone: 516-806-5716
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0001814
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: