Provider Demographics
NPI:1174589246
Name:KORSAKOFF, KRISTOPHER PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTOPHER
Middle Name:PAUL
Last Name:KORSAKOFF
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:20 GRAND STREET
Mailing Address - Street 2:3RD FL
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1035
Mailing Address - Country:US
Mailing Address - Phone:845-987-3901
Mailing Address - Fax:845-987-5979
Practice Address - Street 1:212 STATE ROUTE 94
Practice Address - Street 2:SUITE 1A
Practice Address - City:VERNON
Practice Address - State:NJ
Practice Address - Zip Code:07462
Practice Address - Country:US
Practice Address - Phone:973-864-6029
Practice Address - Fax:973-864-1010
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2016-08-02
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Provider Licenses
StateLicense IDTaxonomies
NY235632207RG0100X
NJMA72514207RG0100X
PAMD425976207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology