Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 269467 | NY |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 269467 | NY |
NPI | 1194961078 |
---|---|
Provider Name | Yevgeniy A Korshunov |
First Address | New York, NY 10075-1851 |
Second Address | Staten Island, NY 10306-2553 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2008 |
Last Update Date | 10/08/2014 |