Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OEG001070 | PA |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | OEG001070 | PA |
NPI | 1346200268 |
---|---|
Provider Name | Dr. Daniel Korn |
First Address | Vienna, VA 22182-3970 |
Second Address | Carlisle, PA 17013-4122 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 13/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T27767 | (02) | PA |