Korotun, Igor

Korotun, Igor is an individual health care provider with primary practice located at 90-79 Sutphin Blvd , Jamaica NY 11435. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Korotun, Igor can be contacted via phone (718) 657-5068.

Contact Information

Primary practice address
90-79 Sutphin Blvd Jamaica NY 11435
Phone: (718) 657-5068
Fax: (718) 526-5930
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 044363 New York

Profile Details

NPI number 1760452460
LBN Legal business name Korotun, Igor
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760452460 NPPES
New York MEDICAID 01433325

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