Provider Demographics
NPI:1093730731
Name:KORTH, VICTORIA FRANCES (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:FRANCES
Last Name:KORTH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:110 BASTIAN RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-1122
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2273 S CLINTON AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2623
Practice Address - Country:US
Practice Address - Phone:585-473-8950
Practice Address - Fax:585-473-2288
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1641412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA6805Medicare ID - Type Unspecified
NYF90774Medicare UPIN