Healthcare Provider Details

I. General information

NPI: 1205050739
Provider Name (Legal Business Name): TIMOTHY P KORYTKO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PATROON CREEK BLVD STE 1
ALBANY NY
12206-5014
US

IV. Provider business mailing address

449 ROUTE 146 STE 101
HALFMOON NY
12065-3239
US

V. Phone/Fax

Practice location:
  • Phone: 518-489-0044
  • Fax: 518-489-3591
Mailing address:
  • Phone: 518-373-3800
  • Fax: 518-373-3808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number273258
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: