Doctor Name: | DR. EVGENIA KORYTNAYA |
NPI Number: | 1093915464 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | MT189707 |
Business Practice Address: | 757 45th Ave Ste. 201 Munster, IN - 463212911 |
Business Phone Number: | 2199342461 |
Business Fax Number: | 2199342478 |
Mailing Address: | 761 45th Ave, Ste. 110 MUNSTER |
State: | IN |
Postal Code: | 463212893 |
Phone Number: | 2199223020 |
Fax Number: | 2199223023 |
NPI Enumeration Date: | 07/23/2007 |
NPI Last Update Date: | 09/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | MT189707 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |