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General NPI Number Information
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NPI Number | 1962553966
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Entity Type | Individual
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Provider Name | JAMIE KORNBLUTH MPT
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Gender | Female
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 02/01/2016
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Provider Practice Location Address
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Address Line | 83 PRINCETON AVE SUITE 3B
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City | HOPEWELL
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State | NJ
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Zip | 08525
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Country | US
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Telephone | 609-466-9004
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Fax | 609-466-9074
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Provider Business Mailing Address
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Address Line | 812 SILVIA ST SUITE 3B
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City | EWING
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State | NJ
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Zip | 08628-3239
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Country | US
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Telephone | 609-644-3822
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Fax | 609-644-3817
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA00897700
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License Number State | NJ
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