Individual provider Active NPI

Dina Halpern Kornblau, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Bronx, NY
National Provider Identifier
1881663961
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
190290 1 Issued in NC
Practice address
2385 Arthur Ave
Suite 206
Bronx, NY 10458-8184
Phone
(718) 220-9755
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 190290 1 NC Primary

Addresses

Primary practice location

2385 Arthur Ave
Suite 206
Bronx, NY 10458-8184

Mailing address

7941 212TH St
Oakland Gardens, NY 11364-3505
Phone (718) 479-4541

Other identifiers 1

IdentifierTypeStateIssuer
01782829-01GPMedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
190290 1NCMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SBH Physicians, PC Past Accepting new patients
Arthur Avenue Pediatrics PC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327276800000",
    "number": "1881663961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7941 212TH ST",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113643505",
            "telephone_number": "718-479-4541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2385 ARTHUR AVE",
            "address_2": "SUITE 206",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104588184",
            "telephone_number": "718-220-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNBLAU",
        "first_name": "DINA",
        "middle_name": "HALPERN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2012-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NC",
            "license": "190290 1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01782829-01GP",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; 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.