Healthcare Provider Details

I. General information

NPI: 1346569993
Provider Name (Legal Business Name): KATHRYNE GEORGIANA CORONA RN, CNM, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2010
Last Update Date: 09/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 AUDUBON AVE FIRST FLOOR
NEW YORK NY
10032-3784
US

IV. Provider business mailing address

680 FORT WASHINGTON AVE 2D
NEW YORK NY
10040-3975
US

V. Phone/Fax

Practice location:
  • Phone: 212-342-3200
  • Fax:
Mailing address:
  • Phone: 347-563-8237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number480120
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberF360432-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberF000721-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: