Provider Demographics
NPI:1407857410
Name:COREN, ALFRED B (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:B
Last Name:COREN
Suffix:
Gender:M
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:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-0129
Mailing Address - Country:US
Mailing Address - Phone:814-765-7314
Mailing Address - Fax:814-339-6165
Practice Address - Street 1:809 TURNPIKE AVE
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-1232
Practice Address - Country:US
Practice Address - Phone:814-765-7314
Practice Address - Fax:814-339-6165
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042529E2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011390320008Medicaid
PA0011390320008Medicaid
PA533181JAAMedicare PIN