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General NPI Number Information
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NPI Number | 1972748317
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Entity Type | Individual
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Provider Name | NANCY COBA PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 12/15/2008
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Last Update Date | 07/24/2012
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Provider Practice Location Address
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Address Line | 505 BOULEVARD
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City | KENILWORTH
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State | NJ
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Zip | 07033-1603
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Country | US
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Telephone | 201-303-2289
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Fax |
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Provider Business Mailing Address
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Address Line | 124 LINCOLN AVE
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City | SADDLE BROOK
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State | NJ
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Zip | 07663-5209
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Country | US
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Telephone | 201-303-2289
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Fax |
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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 | 35SI00481700
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License Number State | NJ
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