MEDICARE: ROBIN KORNGOLD MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	R048123	NY

General Provider Information

NPI Number	:	1013249317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN KORNGOLD MSW

Provider Business Mailing Address
First Line	:	125 S MAIN ST
Second Line	:
City	:	NEW CITY
State	:	NY
Zip	:	10956-3501
Country	:	US
Telephone Number	:	845-638-2822
Fax Number	:	845-926-1887

Provider Business Practice Location Address
First Line	:	125 S MAIN ST
Second Line	:
City	:	NEW CITY
State	:	NY
Zip	:	10956-3501
Country	:	US
Telephone Number	:	845-638-2822
Fax Number	:	845-926-1887

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2010
Last Update Date	:	02/13/2026

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