Healthcare Provider Details

I. General information

NPI: 1407014640
Provider Name (Legal Business Name): JAMEELA KOBEISSI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2008
Last Update Date: 05/01/2023
Certification Date: 05/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 MAIDEN LN 6TH FLOOR
NEW YORK NY
10038-4812
US

IV. Provider business mailing address

300 CADMAN PLZ W FL 17
BROOKLYN NY
11201-3229
US

V. Phone/Fax

Practice location:
  • Phone: 212-780-2378
  • Fax: 212-505-0724
Mailing address:
  • Phone: 718-822-1818
  • Fax: 347-916-1906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number253706
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: