MEDICARE: DR. VLAD KORBEN MD, PHD

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	390200000X	Student in an Organized Health Care Education/Training Program	339689	NY

General Provider Information

NPI Number	:	1356084503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VLAD KORBEN MD, PHD

Provider Business Mailing Address
First Line	:	622 W 168TH ST PH 15-124
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-3720
Country	:	US
Telephone Number	:	332-257-7741
Fax Number	:

Provider Business Practice Location Address
First Line	:	622 W 168TH ST PH 15-124
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-3720
Country	:	US
Telephone Number	:	332-257-7741
Fax Number	:

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

Provider Enumeration Date	:	04/15/2022
Last Update Date	:	03/18/2026

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