Provider Demographics
NPI:1700021862
Name:CORWIN, MARY BARBARA (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:BARBARA
Last Name:CORWIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:BARBARA
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:417 LIBERTY ST
Mailing Address - Street 2:SUITE2120
Mailing Address - City:PENN YAN
Mailing Address - State:NY
Mailing Address - Zip Code:14527-1100
Mailing Address - Country:US
Mailing Address - Phone:315-536-5160
Mailing Address - Fax:315-536-5146
Practice Address - Street 1:417 LIBERTY ST
Practice Address - Street 2:SUITE2120
Practice Address - City:PENN YAN
Practice Address - State:NY
Practice Address - Zip Code:14527-1100
Practice Address - Country:US
Practice Address - Phone:315-536-5160
Practice Address - Fax:315-536-5146
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY410131-1163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management