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General NPI Number Information
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NPI Number | 1467546705
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Entity Type | Individual
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Provider Name | SANDER JAY KORNBLITH PH.D.
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 04/18/2024
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Provider Practice Location Address
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Address Line | 700 BLAW AVE STE 201
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City | PITTSBURGH
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State | PA
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Zip | 15238-3216
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Country | US
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Telephone | 412-967-0610
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Fax | 412-968-0527
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Provider Business Mailing Address
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Address Line | 700 BLAW AVE STE 201
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City | PITTSBURGH
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State | PA
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Zip | 15238-3216
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Country | US
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Telephone | 412-559-4364
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Fax | 412-968-0527
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS003630L
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License Number State | PA
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