Healthcare Provider Details

I. General information

NPI: 1861642811
Provider Name (Legal Business Name): DANIEL HARRIS KORT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2008
Last Update Date: 08/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 SHREWSBURY AVE SUITE 300
SHREWSBURY NJ
07702-4179
US

IV. Provider business mailing address

227 LAUREL RD SUITE 300
VOORHEES NJ
08043-8303
US

V. Phone/Fax

Practice location:
  • Phone: 732-758-6511
  • Fax: 732-758-1048
Mailing address:
  • Phone: 856-669-6025
  • Fax: 856-651-0794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number25MA09453200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: