Provider Demographics
NPI:1033162540
Name:COTRONEO, MARIJANE (WHNP)
Entity Type:Individual
Prefix:
First Name:MARIJANE
Middle Name:
Last Name:COTRONEO
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4041 DELAWARE AVENUE
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150
Mailing Address - Country:US
Mailing Address - Phone:716-876-5512
Mailing Address - Fax:716-876-7342
Practice Address - Street 1:4041 DELAWARE AVENUE
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150
Practice Address - Country:US
Practice Address - Phone:716-876-5512
Practice Address - Fax:716-876-7342
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF4202491363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
000560138004OtherBCBS
0086173OtherGHI
156780CKOtherPREFERRED CARE
9511748OtherINDEPENDENT HEALTH
F4206491OtherNYS LICENSE
F4206491OtherNYS LICENSE