Provider Demographics
NPI:1336129949
Name:MARRON-CORWIN, MARY-JOAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY-JOAN
Middle Name:
Last Name:MARRON-CORWIN
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 1:506 LENOX AVE
Mailing Address - Street 2:MLK 4417
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-1802
Mailing Address - Country:US
Mailing Address - Phone:212-939-8457
Mailing Address - Fax:212-939-1911
Practice Address - Street 1:506 LENOX AVE
Practice Address - Street 2:MLK 4417
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1802
Practice Address - Country:US
Practice Address - Phone:212-939-8457
Practice Address - Fax:212-939-1911
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1749442080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01106183Medicaid
NY01106183Medicaid
NYF67483Medicare UPIN