Provider Demographics
NPI:1942313358
Name:KORSTEN, MARK ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALLEN
Last Name:KORSTEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:130 W. KINGSBRIDGE ROAD
Mailing Address - Street 2:JAMES J. PETERS VA MEDICAL CENTER
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468
Mailing Address - Country:US
Mailing Address - Phone:718-584-9000
Mailing Address - Fax:718-741-4233
Practice Address - Street 1:130 W. KINGSBRIDGE ROAD
Practice Address - Street 2:JAMES J. PETERS VA MEDICAL CENTER
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468
Practice Address - Country:US
Practice Address - Phone:718-584-9000
Practice Address - Fax:718-741-4233
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY109515207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology