MEDICARE: DR. MARY-JOAN MARRON-CORWIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080N0001X	Neonatal-Perinatal Medicine Physician	174944	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336129949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY-JOAN MARRON-CORWIN M.D.

Provider Business Mailing Address
First Line	:	506 LENOX AVE
Second Line	:	MLK 4417
City	:	NEW YORK
State	:	NY
Zip	:	10037-1802
Country	:	US
Telephone Number	:	212-939-8457
Fax Number	:	212-939-1911

Provider Business Practice Location Address
First Line	:	506 LENOX AVE
Second Line	:	MLK 4417
City	:	NEW YORK
State	:	NY
Zip	:	10037-1802
Country	:	US
Telephone Number	:	212-939-8457
Fax Number	:	212-939-1911

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	02/27/2015

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