National Provider Identifier
Benjamin J Kornblum
Benjamin J Kornblum is listed in the NPPES registry with a primary specialty of Family Nurse Practitioner in Ithaca, NY and a listed phone number of (607) 697-0360.
Profile Overview
- NPI
- 1093337446
- Provider Type
- Individual
- Primary Specialty
- Family Nurse Practitioner
- Enumeration Date
- May 08, 2020
- Last Updated
- July 30, 2020
Practice Location
- 302 W Seneca St
- Ithaca, NY 14850-4130
Phone: (607) 697-0360
Specialties
- Family Nurse Practitioner (363LF0000X)
Full Record
- NPI
- 1093337446
- Entity Type
- Individual
- Last Name
- Kornblum
- First Name
- Benjamin
- Middle Name
- J
- Name Prefix
- Mr.
- Mailing Street Address
- 302 W Seneca St
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-4130
- Mailing Country
- US
- Mailing Phone
- (607) 697-0360
- Mailing Fax
- (607) 272-0240
- Practice Street Address
- 302 W Seneca St
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-4130
- Practice Country
- US
- Practice Phone
- (607) 697-0360
- Enumeration Date
- May 08, 2020
- Last Updated
- July 30, 2020
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- July 30, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Family Nurse Practitioner (363LF0000X)