Provider Demographics
NPI:1598467292
Name:AGMAN, CORINNE (FNP)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:AGMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 9TH AVE APT 14J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5731
Mailing Address - Country:US
Mailing Address - Phone:516-776-8404
Mailing Address - Fax:
Practice Address - Street 1:45 E 85TH ST STE 1AB
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0957
Practice Address - Country:US
Practice Address - Phone:212-584-7001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF351208-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily