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Individual

DR. CHARLES REUBEN KORROL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
775 PARK AVE, SUITE 200-9, HUNTINGTON, NY 11743-3976
(631) 549-3888
(631) 549-0243
Mailing address
775 PARK AVE, SUITE 200-9, HUNTINGTON, NY 11743-3976
(631) 549-3888
(631) 549-0243

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
095661
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00625470
NY
Enumeration date
08/13/2006
Last updated
04/20/2010
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