MEDICARE: MISS EUNICE VICTORIA CORONA PA

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	363A00000X	Physician Assistant	011520	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

General Provider Information

NPI Number	:	1538236716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS EUNICE VICTORIA CORONA PA

Provider Business Mailing Address
First Line	:	440 W 114TH ST
Second Line	:	MUL2 SECTION D
City	:	NEW YORK
State	:	NY
Zip	:	10025-1796
Country	:	US
Telephone Number	:	212-523-4799
Fax Number	:	212-523-1761

Provider Business Practice Location Address
First Line	:	440 W 114TH ST
Second Line	:	MUL2 SECTION D
City	:	NEW YORK
State	:	NY
Zip	:	10025-1796
Country	:	US
Telephone Number	:	212-523-4799
Fax Number	:	212-523-1761

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

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	10/19/2010

Similar Medicare Providers

1710546965 — DR. MICHAEL WILLIAM BOURNE DO
Practice Location Address:

440 W 114TH ST STE 220
NEW YORK, NY
10025-1796

Practice Phone: 212-523-4000
Practice Fax:

1861074734 — VLADIMIR FALB DO
Practice Location Address:

440 W 114TH ST
NEW YORK, NY
10025-1796

Practice Phone: 212-523-8672
Practice Fax:

1902666001 — HAFSA MAMUN
Practice Location Address:

440 W 114TH ST
NEW YORK, NY
10025-1796

Practice Phone: 646-732-9722
Practice Fax:

1962414672 — DR. KHALID DAR MD
Practice Location Address:

440 W 114TH ST
NEW YORK, NY
10025-1796

Practice Phone: 212-523-8570
Practice Fax:

1386704302 — DR. DIANA NURUTDINOVA MD
Practice Location Address:

440 W 114TH ST , 6TH FLOOR
NEW YORK, NY
10025-1796

Practice Phone: 212-523-4000
Practice Fax: 212-523-5677

1114169844 — MS. WENDY CHERYL DAISLEY FNP
Practice Location Address:

440 W 114TH ST , CLARKE 2 AREA H
NEW YORK, NY
10025-1796

Practice Phone: 212-523-3356
Practice Fax: 212-523-4553

Directions to “ MISS EUNICE VICTORIA CORONA PA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.