Michelle Elizabeth Korn, BCBA

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

025811 Issued in NY

Practice address

460 Midland Ave
Staten Island, NY 10306-5104

Phone

(718) 667-7770

NPI assigned

Jan 21, 2020

Last updated

Jul 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1205466190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SYCAMORE ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103082650",
            "telephone_number": "917-710-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 MIDLAND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103065104",
            "telephone_number": "718-667-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORN",
        "first_name": "MICHELLE",
        "middle_name": "ELIZABETH",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-21",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "025811",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "1-19-35845",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronika Korcakova, M.S.SPED
• Jamie Korenberg, DO
• Sakshi Korgaonkar
• Miriam Susan Korik, OD
• Nedzmie Korkut
• Varda Korn, CCC-SLP
• Nancy Carol Korngold, LMHC
• Zoya Koroleva
• William M Korosh, PH.D.
• Gabriel Marcel Korotkin, RN

• Occupational Therapist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.