Provider Demographics
NPI:1235321910
Name:CORCORAN, ANTHONY PAUL (FNP)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:PAUL
Last Name:CORCORAN
Suffix:
Gender:M
Credentials:FNP
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Mailing Address - Street 1:1803 MOUNT ROSE AVE
Mailing Address - Street 2:SUITE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3026
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-3498
Practice Address - Street 1:605 S GEORGE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17401-3160
Practice Address - Country:US
Practice Address - Phone:717-851-2334
Practice Address - Fax:717-851-3498
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2016-06-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PASP011888363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1604783OtherGATEWAY MEDICARE ASSURED
S97924Medicare UPIN
PA1604783OtherGATEWAY MEDICARE ASSURED