MEDICARE: DR. DAVID CORON PHD

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
1	103TC0700X	Clinical Psychologist	06580	NY
2	103TC2200X	Clinical Child & Adolescent Psychologist	06580	NY
3	103TF0200X	Forensic Psychologist	06580	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	103255FC	OTHER	NY	PREFERRED CARE

General Provider Information

NPI Number	:	1346256591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID CORON PHD

Provider Business Mailing Address
First Line	:	6137 COUNTY ROAD 41
Second Line	:
City	:	FARMINGTON
State	:	NY
Zip	:	14425-8931
Country	:	US
Telephone Number	:	585-924-3120
Fax Number	:	585-924-3120

Provider Business Practice Location Address
First Line	:	6137 COUNTY ROAD 41
Second Line	:
City	:	FARMINGTON
State	:	NY
Zip	:	14425-8931
Country	:	US
Telephone Number	:	585-924-3120
Fax Number	:	585-924-3120

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	09/11/2025

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