Provider Demographics
NPI:1144249061
Name:KORNHABER, ARLENE (MS,CCC-A)
Entity type:Individual
Prefix:MS
First Name:ARLENE
Middle Name:
Last Name:KORNHABER
Suffix:
Gender:F
Credentials:MS,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 406153
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-1876
Mailing Address - Country:US
Mailing Address - Phone:201-854-1800
Mailing Address - Fax:201-861-0269
Practice Address - Street 1:6038 BERGENLINE AVE
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-1421
Practice Address - Country:US
Practice Address - Phone:201-854-1800
Practice Address - Fax:201-861-0269
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ443231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2450058Q6XMedicare PIN