Provider Demographics
NPI:1366788051
Name:KORN, CHAVA M (MS ED)
Entity type:Individual
Prefix:MRS
First Name:CHAVA
Middle Name:M
Last Name:KORN
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 43RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-1605
Mailing Address - Country:US
Mailing Address - Phone:718-633-0890
Mailing Address - Fax:
Practice Address - Street 1:1518 43RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-1605
Practice Address - Country:US
Practice Address - Phone:718-633-0890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-27
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist