Active NPI
Mitchell Paul Kornhaber, M.A.
- Student in an Organized Health Care Education/Training Program
- Manhasset, NY
National Provider Identifier
1124368162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 400 Community Dr
Manhasset, NY 11030-3815 - Phone
- (516) 562-2555
- Fax
- (516) 347-3483
- NPI assigned
- Feb 28, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
400 Community Dr
Manhasset, NY 11030-3815
Mailing address
39 E Springfield St
Apt. 2
Boston, MA 02118-3355
Phone (516) 241-4149
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160622000683 | NY | Order and Referring Only - Other (Physician) | 7214228279 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 057439 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362009600000",
"number": "1124368162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 E SPRINGFIELD ST",
"address_2": "APT. 2",
"city": "BOSTON",
"state": "MA",
"postal_code": "021183355",
"telephone_number": "516-241-4149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 COMMUNITY DR",
"city": "MANHASSET",
"state": "NY",
"postal_code": "110303815",
"telephone_number": "516-562-2555",
"fax_number": "516-347-3483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORNHABER",
"first_name": "MITCHELL",
"middle_name": "PAUL",
"name_prefix": "Mr.",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-02-28",
"last_updated": "2013-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manhasset, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.