| Doctor Name: | NANCY CORNBLATT |
| NPI Number: | 1003959842 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 44SC00435900 |
| Business Practice Address: | Preferred Behavioral Health Of Nj Cpsai Program 700 Airport Road Lakewood, NJ - 08701 |
| Business Phone Number: | 7323674700 |
| Business Fax Number: | |
| Mailing Address: | 52 Mill Creek Rd, BAYVILLE |
| State: | NJ |
| Postal Code: | 087211339 |
| Phone Number: | 7322780282 |
| Fax Number: | |
| NPI Enumeration Date: | 02/14/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 44SC00435900 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |