Individual
VIRGILIO CORONADO VICENTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
155 JEFFERSON ST, SUITE # 3, NEWARK, NJ 07105-1706
(973) 466-0300
(973) 466-1117
Mailing address
PO BOX 254, WEST ORANGE, NJ 07052-0254
(973) 466-0300
(973) 466-1117
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA06381500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01000200800
AMERICHOICE
—
01
—
01000200803
AMERICHOICE
—
01
—
1135312
HORIZON NJ HEALTH
—
01
—
2017754
UNITED HEALTH CARE
—
01
—
2072459000
AMERIHEALTH PPO HMO
—
01
—
2327481
AETNA
—
01
—
2366072
AETNA
—
01
—
25087
UNIVERSITY HEALTH PLANS
—
01
—
2695833
GHI
—
01
—
2K5847
ACS HEALTHNET
—
01
—
607241
EMPIRE
—
01
—
7949804
UNISYS MEDICAID
—
05
—
7949804
—
NJ
01
—
8763000
CIGNA
—
01
—
8763000002
CIGNA
—
01
—
91899
AMERICAID
—
01
—
K0845
HORIZON BCBS
—
01
—
P3512598
OXFORD
—
Enumeration date
08/21/2006
Last updated
08/25/2016
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