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General NPI Number Information
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NPI Number | 1740384379
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Entity Type | Individual
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Provider Name | CORINNE E DE CHOLNOKY M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 166 W BROAD ST SUITE 201
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City | STAMFORD
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State | CT
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Zip | 06902-3661
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Country | US
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Telephone | 203-325-9710
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Fax | 203-325-0176
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Provider Business Mailing Address
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Address Line | 166 W BROAD ST SUITE 201
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City | STAMFORD
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State | CT
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Zip | 06902-3661
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Country | US
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Telephone | 203-325-9710
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Fax | 203-325-0176
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 025249
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0101032332
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | D0025131
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License Number State | MD
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