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General NPI Number Information
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NPI Number | 1184241853
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Entity Type | Individual
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Provider Name | CORA-ANN O'REGAN NP
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Gender | Female
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Dates
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Enumeration Date | 06/29/2020
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 78 TODT HILL RD STE 110
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City | STATEN ISLAND
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State | NY
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Zip | 10314-4528
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Country | US
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Telephone | 212-776-9090
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Fax |
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Provider Business Mailing Address
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Address Line | 3 PIPER CT
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City | SAINT JAMES
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State | NY
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Zip | 11780-1419
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Country | US
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Telephone | 347-993-9693
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F343475-1
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License Number State | NY
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