Charles Reuben Korrol, DO

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

095661 Issued in NY

Practice address

775 Park Ave
Suite 200-9
Huntington, NY 11743-3976

Phone

(631) 549-3888

Fax

(631) 549-0243

NPI assigned

Aug 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dr. Charles Korrol

  • Psychiatry Physician
  • Huntington, NY
  • NPI 1902043029
  NPD (past) Authorized official

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271721600000",
    "number": "1528070083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 PARK AVE",
            "address_2": "SUITE 200-9",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433976",
            "telephone_number": "631-549-3888",
            "fax_number": "631-549-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 PARK AVE",
            "address_2": "SUITE 200-9",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433976",
            "telephone_number": "631-549-3888",
            "fax_number": "631-549-0243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORROL",
        "first_name": "CHARLES",
        "middle_name": "REUBEN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2010-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "095661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00625470",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy R Koreen, M.D.
• Jason Koreen
• Roger Koreen, MD
• Ralph Kornblatt, OD
• Amy Helen Korobow
• Alexis Kosakavich
• Kerri Lynn Kosloff, LCSW
• Phyllis Kossak, PHD
• Monika Lillian Kost, PA
• Tara Marie Kotliar

• Child & Adolescent Psychiatry Physician in Huntington, NY
• Providers in Huntington, NY by specialty
• Child & Adolescent Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2010; 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.