Provider Demographics
NPI:1578737482
Name:CORCORAN, MARGARET MULLOY (FNP)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:MULLOY
Last Name:CORCORAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:MARGARET
Other - Middle Name:R
Other - Last Name:MULLOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1300 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14222-1004
Mailing Address - Country:US
Mailing Address - Phone:716-878-6711
Mailing Address - Fax:
Practice Address - Street 1:1300 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222-1004
Practice Address - Country:US
Practice Address - Phone:716-878-6711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335430363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily