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General NPI Number Information
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NPI Number | 1225153067
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Entity Type | Individual
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Provider Name | DANIEL C KORMAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 1646 BRENTWOOD RD
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City | BRENTWOOD
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State | NY
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Zip | 11717-5534
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Country | US
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Telephone | 631-231-5200
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Fax | 631-231-4431
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Provider Business Mailing Address
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Address Line | 6939 YELLOWSTONE BLVD APT 503
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City | FOREST HILLS
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State | NY
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Zip | 11375-3730
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Country | US
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Telephone | 347-527-2672
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 175295
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License Number State | NY
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