Provider Demographics
NPI:1023367406
Name:COREY W HUNTER, MD PLLC
Entity Type:Organization
Organization Name:COREY W HUNTER, MD PLLC
Other - Org Name:AINSWORTH PAIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COREY
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-302-4552
Mailing Address - Street 1:PO BOX 270
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-0270
Mailing Address - Country:US
Mailing Address - Phone:631-264-2035
Mailing Address - Fax:631-264-1418
Practice Address - Street 1:115 E 57TH ST
Practice Address - Street 2:SUITE 1210
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2032
Practice Address - Country:US
Practice Address - Phone:212-203-2813
Practice Address - Fax:646-607-9061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-31
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty