Provider Demographics
NPI:1548437080
Name:DR. ROBERT KORNFELD
Entity type:Organization
Organization Name:DR. ROBERT KORNFELD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:KORNFELD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:516-869-3338
Mailing Address - Street 1:1 HOLLOW LN
Mailing Address - Street 2:STE 105
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1215
Mailing Address - Country:US
Mailing Address - Phone:516-869-3338
Mailing Address - Fax:516-869-5715
Practice Address - Street 1:1 HOLLOW LN
Practice Address - Street 2:STE 105
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1215
Practice Address - Country:US
Practice Address - Phone:516-869-3338
Practice Address - Fax:516-869-5715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN3101261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP33281Medicare PIN
NYT50959Medicare UPIN