Individual
MAURA C COBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(603) 860-9816
Mailing address
217 51ST AVE APT 511, LONG ISLAND CITY, NY 11101-5870
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
688228
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
382939
NY
Other
Enumeration date
02/12/2019
Last updated
04/26/2021
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