Healthcare Provider Details

I. General information

NPI: 1902018203
Provider Name (Legal Business Name): STEPHEN WAYNE KOBRIN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MAMARONECK AVE 2ND FLOOR
WHITE PLAINS NY
10601-4263
US

IV. Provider business mailing address

3 CHARLOTTES WAY
DANBURY CT
06811-2708
US

V. Phone/Fax

Practice location:
  • Phone: 914-357-1779
  • Fax: 203-798-7294
Mailing address:
  • Phone: 914-357-1779
  • Fax: 203-798-7294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX008899
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: