Provider Demographics
NPI:1538284559
Name:ANDERSON-CORPENING, VERONICA DOROTHY (MD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:DOROTHY
Last Name:ANDERSON-CORPENING
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 1:215A N CENTER DR
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-4247
Mailing Address - Country:US
Mailing Address - Phone:732-398-1111
Mailing Address - Fax:732-398-1136
Practice Address - Street 1:215A N CENTER DR
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-4247
Practice Address - Country:US
Practice Address - Phone:732-398-1111
Practice Address - Fax:732-398-1136
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06430300207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG36487Medicare UPIN
NJ893763Medicare ID - Type Unspecified