Molly M Kornblum

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

339781 Issued in NY

Practice address

620 W Seneca St
Ithaca, NY 14850-3326

Phone

(607) 273-1526

Fax

(607) 216-0039

NPI assigned

Aug 13, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Planned Parenthood of Greater New York Inc

  • Ambulatory Family Planning Facility
  • Brooklyn, NY
  • NPI 1417959701
  NPD

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

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439424000000",
    "number": "1770959710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W SENECA ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503326",
            "telephone_number": "607-273-1526",
            "fax_number": "607-216-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W SENECA ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503326",
            "telephone_number": "607-273-1526",
            "fax_number": "607-216-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNBLUM",
        "first_name": "MOLLY",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-13",
        "last_updated": "2015-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "339781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Elizabeth Kooperman, N.P., M.S.N., C.S.
• Carolyn Koppel, N.P.
• Edward Koppel, M.D.
• Benjamin J Kornblum
• Daniel M Kornblum, RN
• Kory Marsland Corporation
• Kory Marsland Corporation
• Catherine Irene Kovacik, PHARM. D.
• Lindsay N Citro Kozinsky, MS, CCC-SLP
• Sharon S. Kozlowski, CFNP

• Family Nurse Practitioner in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; 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.

Verify at the official NPI Registry.