Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 029919 | NY |
NPI | 1205090180 |
---|---|
Provider Name | Dr. Leonard Bruce Kobren |
First Address | White Plains, NY 10605-2025 |
Second Address | White Plains, NY 10605-2025 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2008 |
Last Update Date | 10/07/2008 |