Provider Demographics
NPI:1225153067
Name:KORMAN, DANIEL C (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:C
Last Name:KORMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6939 YELLOWSTONE BLVD APT 503
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3730
Mailing Address - Country:US
Mailing Address - Phone:347-527-2672
Mailing Address - Fax:
Practice Address - Street 1:1646 BRENTWOOD RD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-5534
Practice Address - Country:US
Practice Address - Phone:631-231-5200
Practice Address - Fax:631-231-4431
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175295207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA62256Medicare UPIN
NY33E451Medicare ID - Type Unspecified