Provider Demographics
NPI:1114353190
Name:MATTHEW E KORNER PSYD PC
Entity Type:Organization
Organization Name:MATTHEW E KORNER PSYD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:EMANUEL
Authorized Official - Last Name:KORNER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:917-916-9052
Mailing Address - Street 1:4 DOGWOOD CLOSE
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1905
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:245 E 13TH ST
Practice Address - Street 2:GROUND FLOOR, APT 4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-5641
Practice Address - Country:US
Practice Address - Phone:917-916-9052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty