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General NPI Number Information
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NPI Number | 1992260889
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Entity Type | Organization
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Legal Business Name | VADIM KOROL NP IN PSYCHIATRY PC
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Dates
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Enumeration Date | 02/05/2019
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Last Update Date | 02/12/2019
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Provider Practice Location Address
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Address Line | 390 HOWARD AVE
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City | FRANKLIN SQUARE
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State | NY
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Zip | 11010-3341
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Country | US
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Telephone | 718-869-9060
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Fax |
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Provider Business Mailing Address
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Address Line | 390 HOWARD AVE
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City | FRANKLIN SQUARE
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State | NY
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Zip | 11010-3341
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Country | US
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Telephone | 718-869-9060
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. VADIM KOROL
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Credential | NP
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Telephone | 718-869-9060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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