Basic Information
Provider Information
NPI: 1205045416
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KORIN
FirstName: LAURA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 129 W 29TH ST FL 10
Address2:  
City: NEW YORK
State: NY
PostalCode: 100015105
CountryCode: US
TelephoneNumber: 4156586791
FaxNumber: 4155200904
Practice Location
Address1: 680 WHITE PLAINS RD
Address2:  
City: SCARSDALE
State: NY
PostalCode: 105835042
CountryCode: US
TelephoneNumber: 8886636331
FaxNumber: 2128674353
Other Information
ProviderEnumerationDate: 05/22/2007
LastUpdateDate: 05/03/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/03/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XMD439288PAN Allopathic & Osteopathic PhysiciansFamily Medicine 
2083P0901X261523NYN Allopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
207Q00000X261523NYY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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