Organization
PEDIATRICS OF RICHMOMD COUNTY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARINA A CORPUS MD (PRESIDENT)
(718) 816-0640
Entity
Organization
Contact information
Practice address
491 HENDERSON AVE, STATEN ISLAND, NY 10310-1665
(718) 816-0640
(718) 816-6662
Mailing address
491 HENDERSON AVE, STATEN ISLAND, NY 10310-1665
(718) 816-0640
(718) 816-6662
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
104893
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00182485
—
NY
Enumeration date
03/18/2014
Last updated
03/18/2014
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