Healthcare Provider Details

I. General information

NPI: 1245560721
Provider Name (Legal Business Name): JEANNE HOPE KOBRITZ CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2010
Last Update Date: 01/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 W 57TH ST STE 204
NEW YORK NY
10019-3158
US

IV. Provider business mailing address

100 MANHATTAN AVE APT # 1217
UNION CITY NJ
07087-5240
US

V. Phone/Fax

Practice location:
  • Phone: 212-603-4160
  • Fax: 212-603-4166
Mailing address:
  • Phone: 201-472-9496
  • Fax: 212-603-4166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberF000171
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: