BRENDA KOBLICK (NPI# 1932136629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1932136629 |
Entity Type | Individual |
Full Name | BRENDA KOBLICK |
Credential | MD |
Practice Address |
365 Montauk Ave New London CT 06320-4700 |
Practice Telephone | 8604445193 |
Practice Fax Number | 8604446851 |
Mailing Telephone | 8604445193 |
Enumeration Date | 2006-06-27 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
023604 | CT | Allopathic & Osteopathic Physicians |
Street Address |
365 MONTAUK AVE |
City | NEW LONDON |
State | CT |
Zip Code | 06320-4700 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568460186 | Steven Lu | Internal Medicine | 365 Montauk Ave, Rm 4.512, New London, CT 06320-4700 | 2005-07-08 |
1407471246 | Lawrence and Memorial Hospital, Inc. | Internal Medicine | 365 Montauk Ave, New London, CT 06320-4700 | 2020-06-08 |
1952954117 | Veronica O Lee | Pharmacist | 365 Montauk Ave, New London, CT 06320-4700 | 2019-07-17 |
1265084487 | Lydia Derienzo | Pharmacist | 365 Montauk Ave, New London, CT 06320-4700 | 2019-07-09 |
1184283699 | Theresa Joan Crino | Pharmacist | 365 Montauk Ave, New London, CT 06320-4700 | 2019-06-08 |
1437718137 | Linda Anderson | Pharmacist | 365 Montauk Ave, New London, CT 06320-4769 | 2019-06-07 |
1265091813 | Stephen Richard Cofone | Pharmacist | 365 Montauk Ave, New London, CT 06320-4700 | 2019-06-07 |
1841859683 | Thomas David Page | Pharmacist | 365 Montauk Ave, New London, CT 06320-4769 | 2019-06-06 |
1942869706 | William Edward Sergiy IIi | Pharmacist | 365 Montauk Ave, New London, CT 06320-4700 | 2019-06-06 |
1578122263 | Mary Stevens | Pharmacist | 365 Montauk Ave, New London, CT 06320-4700 | 2019-06-06 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942824891 | Shilpi Jain | Physical Therapist | 31 Vauxhall Street, Beechwood Post Accute, Transitional, New London, CT 06320 | 2020-06-05 |
1174009641 | Catherine Hinojosa | Nurse Practitioner | 1 Shaws Cove, New London, CT 06320 | 2018-07-17 |
1043668320 | Cultivate & Grow Inc. | Counselor | 302 State St Suite 307, New London, CT 06320 | 2016-05-27 |
1295137263 | Jacqueline Durnell | Registered Nurse | 15 Mohegan Drive, Us Coast Guard Academy Regional Clinic, New London, CT 06320 | 2014-09-22 |
1922427541 | Corina Vendetto | Registered Nurse | 245 Shaw St., New London, CT 06320 | 2014-04-10 |
1912329962 | Janelle Posey-green | Social Worker | 302 State St., Suite 201, New London, CT 06320 | 2014-01-10 |
1750622692 | Cynthia Mitchell | Social Worker | 65b Michael Rd, New London, CT 06320 | 2013-03-01 |
1518254507 | Simon J Shapiro | Physical Medicine & Rehabilitation | 190 Howard Avenue, New London, CT 06320 | 2011-06-29 |
1184876708 | Jane P Genido-trujillo | Nurse Practitioner | 270 Mohegan Ave., Student Health Services, New London, CT 06320 | 2008-10-14 |
1932356284 | Gerard Joseph Ventura | Dentist | 21 Montauk Ave., Suite 102, New London, CT 06320 | 2008-08-19 |
Find all providers in zip 06320 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912944695 | Faruk Soydan | Radiology | 365 Montauk Avenue, New London, CT 06320 | 2006-06-01 |
1285613588 | Sheldon Mark Robbins | Radiology | Lawrence and Memorial Hospital, 365 Montauk Ave., New London, CT 06320-4769 | 2006-01-13 |
1255499380 | John Sutphen | Radiology | 365 Montauk Ave, New London, CT 06320-4700 | 2006-12-04 |
1922166073 | Ocean Radiology Associates, P.C. | Radiology | 365 Montauk Ave, New London, CT 06320-4700 | 2006-12-04 |
1528148038 | Valley Radiologists, P.a. | Radiology | 273 County Rd, New London Hospital, New London, NH 03257-5736 | 2006-10-17 |
1770513301 | Robert Cross | Radiology | 365 Montauk Ave, New London, CT 06320-4700 | 2006-07-03 |
1841227535 | Todd Blue | Radiology | 365 Montauk Ave, New London, CT 06320 | 2006-06-27 |
1649207333 | Leonard Copertino | Radiology | 365 Montauk Ave, New London, CT 06320 | 2006-06-27 |
1821035502 | Ira Sitko | Radiology | 365 Montauk Avenue, New London, CT 06320 | 2006-06-01 |
1407893183 | John Sorrentino | Radiology | 365 Montauk Avenue, New London, CT 06320 | 2006-06-01 |
Find all providers in NEW LONDON |
City | NEW LONDON |
Zip Code | 06320 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.