Provider Demographics
NPI:1538356308
Name:KORZENKO, ADAM JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:JOSEPH
Last Name:KORZENKO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:181 BELLE MEADE RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733
Mailing Address - Country:US
Mailing Address - Phone:631-444-4200
Mailing Address - Fax:631-444-4276
Practice Address - Street 1:6 MEDICAL DRIVE
Practice Address - Street 2:PORT JEFFERSON PROFESSIONAL PARK, SUITE D
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776
Practice Address - Country:US
Practice Address - Phone:631-928-7922
Practice Address - Fax:631-928-9246
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2012-08-28
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Provider Licenses
StateLicense IDTaxonomies
NY242407-1207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology