Healthcare Provider Details

I. General information

NPI: 1720184153
Provider Name (Legal Business Name): DANIEL E KORIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 55TH ST SUNSET PARK FAMILY HEALTH CENTER
BROOKLYN NY
11220-2559
US

IV. Provider business mailing address

220 13TH ST
BROOKLYN NY
11215-4802
US

V. Phone/Fax

Practice location:
  • Phone: 718-630-7942
  • Fax: 718-630-7251
Mailing address:
  • Phone: 718-630-7477
  • Fax: 718-630-7437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number137570
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: