Provider Demographics
NPI:1083627582
Name:CORONA, ROBERT JOHN JR (DO, CPE)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOHN
Last Name:CORONA
Suffix:JR
Gender:M
Credentials:DO, CPE
Other - Prefix:
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Mailing Address - Street 1:224 HARRISON STREET
Mailing Address - Street 2:STE 600
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202
Mailing Address - Country:US
Mailing Address - Phone:315-464-5739
Mailing Address - Fax:315-464-6749
Practice Address - Street 1:750 E. ADAMS STREET
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-464-6751
Practice Address - Fax:315-464-6749
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2016-01-05
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Provider Licenses
StateLicense IDTaxonomies
NY171394207ZN0500X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZN0500XAllopathic & Osteopathic PhysiciansPathologyNeuropathology