Jonathan Mark Korostoff in Philadelphia - Periodontics
Jonathan Mark Korostoff - NPI 1154358042
Jonathan Mark Korostoff is a Periodontics in Philadelphia, Pennsylvania. Jonathan Mark Korostoff practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Jonathan Mark Korostoff is 1154358042. The last update date is 2013-04-02.
Jonathan Mark Korostoff's current location address is 3400 Spruce St, Philadelphia, Pennsylvania. You can contact this provider via phone number 2156623580. The mailing address for Jonathan Mark Korostoff is 3400 Spruce St, Philadelphia, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jonathan Mark Korostoff |
|---|---|
| Address | 3400 Spruce St, Philadelphia, Pennsylvania |
| Phone Number | 2156623580 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | DMD |
NPI Number Detail
| NPI Number | 1154358042 |
|---|---|
| Provider Enumeration Date | 2006-06-27 |
| Last Updated Date | 2013-04-02 |
Provider Mailing Address Detail
| Address | 3400 Spruce St |
|---|---|
| City | Philadelphia |
| State | Pennsylvania (PA) |
| Post Code | 191044206 |
| Phone Number | 2156623580 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
| Licence No | DS024789L |
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Definition: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structure |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 14770200001 | PA | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Jonathan Mark Korostoff by the Centers for Medicare & Medicaid Services?
The Jonathan Mark Korostoff has been assigned the NPI (National Provider Identifier) 1154358042 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please share the complete physical location address where Jonathan Mark Korostoff's facilities are situated?
The facilities of Jonathan Mark Korostoff are physically located at the following address: 3400 Spruce St, Philadelphia, PA, 191044206.
What is Jonathan Mark Korostoff's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Jonathan Mark Korostoff is Periodontics, and the taxonomy code that categorizes this field of expertise is 1223P0300X.
When did Jonathan Mark Korostoff receive its 1154358042 assignment?
The Jonathan Mark Korostoff was assigned its 1154358042 on 2006-06-27, which is the date when this unique identifier was issued to the organization.
As of what date were the details pertaining to Jonathan Mark Korostoff last refreshed?
The information related to the Jonathan Mark Korostoff, including its address, specialty, and other relevant details, was last updated on 2013-04-02.
NPI Number: 1982607784
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