Provider Demographics
NPI:1821185901
Name:KORST, ROBERT J (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:KORST
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 VALLEY HEALTH PLZ
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3628
Mailing Address - Country:US
Mailing Address - Phone:201-634-5365
Mailing Address - Fax:201-634-5382
Practice Address - Street 1:1 VALLEY HEALTH PLZ
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3628
Practice Address - Country:US
Practice Address - Phone:201-634-5365
Practice Address - Fax:201-634-5382
Is Sole Proprietor?:No
Enumeration Date:2006-10-09
Last Update Date:2014-07-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY202994208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF45150Medicare UPIN