Provider Demographics
NPI:1154386852
Name:KORT, DAWNE DRAYTON (MD)
Entity type:Individual
Prefix:DR
First Name:DAWNE
Middle Name:DRAYTON
Last Name:KORT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2292 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-6627
Mailing Address - Country:US
Mailing Address - Phone:631-588-5175
Mailing Address - Fax:
Practice Address - Street 1:656 N WELLWOOD AVENUE
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757
Practice Address - Country:US
Practice Address - Phone:631-225-4227
Practice Address - Fax:631-225-4229
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232038207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine