Individual
EDISA KORAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
10 PEARL ST, PORT CHESTER, NY 10573-4611
(845) 279-5908
Mailing address
6 SOUTH RD APT 2Y, HARRISON, NY 10528-3337
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F402814-01
NY
Other
Enumeration date
01/12/2023
Last updated
01/12/2023
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