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General NPI Number Information
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NPI Number | 1043248131
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Entity Type | Individual
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Provider Name | PEARL KORENBLIT M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 02/11/2008
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Provider Practice Location Address
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Address Line | 1011 CLIFTON AVE FIRST FLOOR
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City | CLIFTON
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State | NJ
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Zip | 07013-3518
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Country | US
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Telephone | 973-928-5490
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Fax | 973-928-5493
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Provider Business Mailing Address
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Address Line | 266 PENNINGTON AVE
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City | PASSAIC
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State | NJ
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Zip | 07055-4645
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Country | US
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Telephone | 973-778-1682
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Fax | 973-778-7233
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 173985
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 65102
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License Number State | NJ
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