Edyta Knobloch | Staten Island, NY • PECOS Search

Edyta Knobloch

Counselor

Behavioral Health & Social Service Providers

1110 South Ave, Staten Island, NY 10314-3403

(347) 273-1290 (347) 245-4141

PECOS Enrollment

Based on the most recent information from CMS, provider Edyta Knobloch does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 1:08 PM.

Profile Details

Provider ID
1336707033
Provider Type
Individual
Full Name
Knobloch, Edyta
Credential
MHC-LP

Gender
Female
Sole Proprietor
No
Enumeration Date
5/29/2019
Last Updated
5/29/2019

Contact Information

Practice Location

1110 South Ave, Staten Island, NY 10314-3403

Unlisted Fax

Mailing Location

143 Oak Ave, Staten Island, NY 10306-4002

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer