Provider Demographics
NPI:1184803462
Name:KORTYNA, GEORGE NMI (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:NMI
Last Name:KORTYNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BARON CT
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-2902
Mailing Address - Country:US
Mailing Address - Phone:401-467-4036
Mailing Address - Fax:
Practice Address - Street 1:1725 MENDON RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-4337
Practice Address - Country:US
Practice Address - Phone:401-333-6100
Practice Address - Fax:401-333-6900
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD06079207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology