Basic Information
Provider Information
NPI: 1770643231
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KORFF
FirstName: ALLAN
MiddleName: L
NamePrefix: MR.
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2101 E JEFFERSON ST
Address2: KAISER PREMANENTE MEDICARE ENROLLMENT
City: ROCKVILLE
State: MD
PostalCode: 208524908
CountryCode: US
TelephoneNumber: 3018162424
FaxNumber:  
Practice Location
Address1: 5100 AUTH WAY
Address2:  
City: SUITLAND
State: MD
PostalCode: 207464207
CountryCode: US
TelephoneNumber: 3017025000
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/12/2006
LastUpdateDate: 01/03/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XAC000290MDY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363L00000X0001151805VAN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363L00000XRN61669DCN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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