Provider Demographics
NPI:1245396142
Name:OXFORD, CORRINA M (MD)
Entity type:Individual
Prefix:
First Name:CORRINA
Middle Name:M
Last Name:OXFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CORRINA
Other - Middle Name:
Other - Last Name:OXFORD-HORREY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:525 E 68TH ST STE J-130
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-4870
Mailing Address - Country:US
Mailing Address - Phone:212-746-7910
Mailing Address - Fax:212-746-8717
Practice Address - Street 1:525 E 68TH ST STE J-130
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4870
Practice Address - Country:US
Practice Address - Phone:212-746-7910
Practice Address - Fax:212-746-8717
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD447214207V00000X, 207VM0101X
NY301604207VC0200X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VC0200XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1245396142Medicaid