Provider Demographics
NPI:1992452171
Name:KOBZA, MATTHEW JOSEPH
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:JOSEPH
Last Name:KOBZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MORGAN TER
Mailing Address - Street 2:
Mailing Address - City:WHARTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07885-1027
Mailing Address - Country:US
Mailing Address - Phone:197-334-9771
Mailing Address - Fax:
Practice Address - Street 1:1401 CHEWS LANDING RD
Practice Address - Street 2:
Practice Address - City:LAUREL SPRINGS
Practice Address - State:NJ
Practice Address - Zip Code:08021-2771
Practice Address - Country:US
Practice Address - Phone:856-454-3104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00815300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional