Provider Demographics
NPI:1043512494
Name:AMBROSI, CORINNE NARDA (MD)
Entity Type:Individual
Prefix:DR
First Name:CORINNE
Middle Name:NARDA
Last Name:AMBROSI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:396 HOBART AVE
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-1826
Mailing Address - Country:US
Mailing Address - Phone:718-557-8705
Mailing Address - Fax:718-725-3977
Practice Address - Street 1:396 HOBART AVE
Practice Address - Street 2:
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078-1826
Practice Address - Country:US
Practice Address - Phone:718-557-8705
Practice Address - Fax:718-725-3977
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190774207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology