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NPI Code Detail

MEDICARE: DR. OLGA CORAZON IRIZARRY MD

MEDICARE: DR. OLGA CORAZON IRIZARRY MD
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
1207V00000XObstetrics & Gynecology Physician25MA11160100NJ
2390200000XStudent in an Organized Health Care Education/Training ProgramMT212721PA
3207V00000XObstetrics & Gynecology PhysicianMD469408PA

General Provider Information

NPI Number : 1316470438
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. OLGA CORAZON IRIZARRY MD
Provider Business Mailing Address
First Line : 4051 FREEMANSBURG AVE
Second Line :
City : EASTON
State : PA
Zip : 18045-5596
Country : US
Telephone Number : 484-503-7474
Fax Number :
Provider Business Practice Location Address
First Line : 4051 FREEMANSBURG AVE
Second Line :
City : EASTON
State : PA
Zip : 18045-5596
Country : US
Telephone Number : 484-503-7474
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2017
Last Update Date : 05/20/2024

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