Healthcare Provider Details

I. General information

NPI: 1245768043
Provider Name (Legal Business Name): NATALIA KOBRENKO OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2017
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 TOWNSHIP LINE RD
ELKINS PARK PA
19027-2220
US

IV. Provider business mailing address

1782 TURK RD
DOYLESTOWN PA
18901-2811
US

V. Phone/Fax

Practice location:
  • Phone: 215-663-6825
  • Fax:
Mailing address:
  • Phone: 215-350-0722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG003294
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: