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NPI Code Detail

MEDICARE: MR. GERALD NEIL KOBLIN PHARMACIST

MEDICARE: MR. GERALD NEIL KOBLIN PHARMACIST
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
1183500000XPharmacist23748NY
2183500000XPharmacist3821CT

General Provider Information

NPI Number : 1396067195
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GERALD NEIL KOBLIN PHARMACIST
Provider Business Mailing Address
First Line : 96 MAIN ST
Second Line :
City : NYACK
State : NY
Zip : 10960-3110
Country : US
Telephone Number : 845-358-0688
Fax Number : 845-358-7966
Provider Business Practice Location Address
First Line : 96 MAIN ST
Second Line :
City : NYACK
State : NY
Zip : 10960-3110
Country : US
Telephone Number : 845-358-0688
Fax Number : 845-358-7966
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2010
Last Update Date : 01/18/2026

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