Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 282610 | NY |
NPI | 1134355753 |
---|---|
Provider Name | Dr. Juan C Correa |
First Address | Brooklyn, NY 11209-3315 |
Second Address | Brooklyn, NY 11209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2009 |
Last Update Date | 15/03/2021 |