Provider Demographics
NPI:1285040006
Name:CORCUERA SOLANO, IDOIA (MD)
Entity Type:Individual
Prefix:DR
First Name:IDOIA
Middle Name:
Last Name:CORCUERA SOLANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE GUSTAVE L. LEVY PLACE
Mailing Address - Street 2:BOX 1234
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6574
Mailing Address - Country:US
Mailing Address - Phone:012-122-4136
Mailing Address - Fax:012-124-2781
Practice Address - Street 1:ONE GUSTAVE L. LEVY PLACE
Practice Address - Street 2:BOX 1234
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:012-122-4136
Practice Address - Fax:012-124-2781
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP931562085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology