Provider Demographics
NPI:1811872575
Name:KOLB, ADELAIDE
Entity type:Individual
Prefix:
First Name:ADELAIDE
Middle Name:
Last Name:KOLB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 LORIMER ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-2221
Mailing Address - Country:US
Mailing Address - Phone:720-210-3560
Mailing Address - Fax:
Practice Address - Street 1:590 LORIMER ST UNIT 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-2221
Practice Address - Country:US
Practice Address - Phone:720-210-3560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach