MEDICARE: DR. JOSHUA LAWRENCE KORTH PSY.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC2200X	Clinical Child & Adolescent Psychologist	022581	NY

General Provider Information

NPI Number	:	1023510450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHUA LAWRENCE KORTH PSY.D

Provider Business Mailing Address
First Line	:	170 W 89TH ST APT 3A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-1911
Country	:	US
Telephone Number	:	240-793-5662
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 W 86TH ST APT 2C
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-3663
Country	:	US
Telephone Number	:	929-269-6850
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2018
Last Update Date	:	06/12/2025

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