Provider Demographics
NPI:1902938434
Name:COBIA, JAMES L (MA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:L
Last Name:COBIA
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 HAMLIN PARMA TOWNLINE RD
Mailing Address - Street 2:
Mailing Address - City:HILTON
Mailing Address - State:NY
Mailing Address - Zip Code:14468-9513
Mailing Address - Country:US
Mailing Address - Phone:585-392-7956
Mailing Address - Fax:585-392-7956
Practice Address - Street 1:240 HAMLIN PARMA TOWNLINE RD
Practice Address - Street 2:
Practice Address - City:HILTON
Practice Address - State:NY
Practice Address - Zip Code:14468-9513
Practice Address - Country:US
Practice Address - Phone:585-392-7956
Practice Address - Fax:585-392-7956
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02275625Medicaid