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General NPI Number Information
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NPI Number | 1356482202
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Entity Type | Individual
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Provider Name | EILEEN M CORCORAN RN, APN,C
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Gender | Female
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 151 STATE ROUTE 10 E SUITE 105
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City | SUCCASUNNA
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State | NJ
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Zip | 07876-1452
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Country | US
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Telephone | 973-584-0002
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Fax |
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Provider Business Mailing Address
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Address Line | 909 MAPLE PATH
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City | NEWTON
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State | NJ
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Zip | 07860-4163
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Country | US
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Telephone | 973-948-6859
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 26NN07350200
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License Number State | NJ
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