Provider Demographics
NPI:1427183995
Name:KOROT, ALLAN (OD)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:
Last Name:KOROT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:HUDSON FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12839-2129
Mailing Address - Country:US
Mailing Address - Phone:518-747-2800
Mailing Address - Fax:518-747-2800
Practice Address - Street 1:156 MAIN STREET
Practice Address - Street 2:
Practice Address - City:HUDSON FALLS
Practice Address - State:NY
Practice Address - Zip Code:12839-2129
Practice Address - Country:US
Practice Address - Phone:518-747-2800
Practice Address - Fax:518-747-2800
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT02621152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY30477BOtherPTAN
T89453Medicare UPIN