Carl Corenblum, MSW,LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

921 E New York Ave
Brooklyn, NY 11203-1309

Phone

(718) 778-0485

NPI assigned

Nov 9, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Eitan Corenblum Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1639611569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 E NEW YORK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 E NEW YORK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031309",
            "telephone_number": "718-778-0485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORENBLUM",
        "first_name": "CARL",
        "credential": "MSW,LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-09",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "KC81202G",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EITAN",
            "last_name": "CORENBLUM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.