Provider Demographics
NPI:1144773342
Name:KORN, PAIGE ADELAIDE (MS)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:ADELAIDE
Last Name:KORN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HALE AVE APT 608
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-1797
Mailing Address - Country:US
Mailing Address - Phone:716-200-3662
Mailing Address - Fax:
Practice Address - Street 1:3961 HILLMAN AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3001
Practice Address - Country:US
Practice Address - Phone:718-548-3451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-25
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027232235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist