Healthcare Provider Details

I. General information

NPI: 1023367406
Provider Name (Legal Business Name): COREY W HUNTER, MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2012
Last Update Date: 03/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 E 57TH ST SUITE 1210
NEW YORK NY
10022-2032
US

IV. Provider business mailing address

PO BOX 270
MASSAPEQUA PARK NY
11762-0270
US

V. Phone/Fax

Practice location:
  • Phone: 212-203-2813
  • Fax: 646-607-9061
Mailing address:
  • Phone: 631-264-2035
  • Fax: 631-264-1418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number StateNY

VIII. Authorized Official

Name: DR. COREY WILLIAM HUNTER
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 305-302-4552