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Individual

MISS EUNICE VICTORIA CORONA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
440 W 114TH ST, MUL2 SECTION D, NEW YORK, NY 10025-1796
(212) 523-4799
(212) 523-1761
Mailing address
440 W 114TH ST, MUL2 SECTION D, NEW YORK, NY 10025-1796
(212) 523-4799
(212) 523-1761

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
011520
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01854282
NY
Enumeration date
11/30/2006
Last updated
10/19/2010
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