Provider Demographics
NPI:1346569993
Name:CORONA, KATHRYNE GEORGIANA (RN, CNM, NP)
Entity Type:Individual
Prefix:
First Name:KATHRYNE
Middle Name:GEORGIANA
Last Name:CORONA
Suffix:
Gender:F
Credentials:RN, CNM, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 FORT WASHINGTON AVE
Mailing Address - Street 2:2D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-3975
Mailing Address - Country:US
Mailing Address - Phone:347-563-8237
Mailing Address - Fax:
Practice Address - Street 1:21 AUDUBON AVE
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3784
Practice Address - Country:US
Practice Address - Phone:212-342-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-21
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY480120163W00000X
NYF360432-1363LX0001X
NYF000721-1367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No163W00000XNursing Service ProvidersRegistered Nurse
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife