Provider Demographics
NPI:1871794289
Name:COBERT, WILLA (PHD)
Entity type:Individual
Prefix:
First Name:WILLA
Middle Name:
Last Name:COBERT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:WILLA
Other - Middle Name:
Other - Last Name:COBERT HIRSCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:1311-1327 LEXINGTON AVE
Mailing Address - Street 2:1I
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10128
Mailing Address - Country:US
Mailing Address - Phone:212-369-5837
Mailing Address - Fax:212-876-8812
Practice Address - Street 1:1311-1327 LEXINGTON AVE
Practice Address - Street 2:1I
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10128
Practice Address - Country:US
Practice Address - Phone:212-369-5837
Practice Address - Fax:212-876-8812
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3816103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical