Individual
CORINA PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
525 E 68TH ST # 124, NEW YORK, NY 10065-4870
(212) 746-5454
Mailing address
575 LEXINGTON AVE, NEW YORK, NY 10022-6102
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
312092
NY
363LG0600X
Gerontology Nurse Practitioner
312092
NY
Other
Enumeration date
03/28/2025
Last updated
06/27/2025
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