Provider Demographics
NPI:1275103566
Name:ORAMA, COREY LYNN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:COREY
Middle Name:LYNN
Last Name:ORAMA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:COREY
Other - Middle Name:LYNN
Other - Last Name:EASTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:345 BLACKSTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4829
Mailing Address - Country:US
Mailing Address - Phone:401-455-6346
Mailing Address - Fax:401-455-6532
Practice Address - Street 1:345 BLACKSTONE BLVD
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4800
Practice Address - Country:US
Practice Address - Phone:401-455-6346
Practice Address - Fax:401-455-6532
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPA01354363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant