| NPI | 1598098477 |
|---|---|
| Professional Name | JACKIE KORNBLUTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL 4333) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 007341) |
| 152W00000X Optometrist (Licence: PA OEG002328) | |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2016-12-08 |