Active NPI
Jeffrey Korn, CCC-SLP
- Speech-Language Pathologist
- East Patchogue, NY
National Provider Identifier
1811278104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4064
- Practice address
- 8 Redlef St
East Patchogue, NY 11772-4521 - Phone
- (631) 475-7781
- Fax
- (631) 447-2329
- NPI assigned
- Aug 31, 2011
- Last updated
- Aug 31, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 4064 | NY | Primary |
Addresses
Primary practice location
8 Redlef St
East Patchogue, NY 11772-4521
Mailing address
8 Redlef St
East Patchogue, NY 11772-4521
Phone (631) 475-7781
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4064 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314748800000",
"number": "1811278104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 REDLEF ST",
"city": "EAST PATCHOGUE",
"state": "NY",
"postal_code": "117724521",
"telephone_number": "631-475-7781",
"fax_number": "631-447-2329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 REDLEF ST",
"city": "EAST PATCHOGUE",
"state": "NY",
"postal_code": "117724521",
"telephone_number": "631-475-7781",
"fax_number": "631-447-2329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORN",
"first_name": "JEFFREY",
"name_prefix": "Mr.",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-31",
"last_updated": "2011-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "4064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Patchogue, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.