Active NPI
Raul Coronado, M.D.
- Family Medicine Physician
- East Stroudsburg, PA
National Provider Identifier
1366564262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 121427-1
- Practice address
- 52 Carly CT
East Stroudsburg, PA 18301-8004 - Phone
- (201) 522-0577
- Fax
- (646) 349-1395
- NPI assigned
- Apr 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 121427-1 | NY | Primary |
Addresses
Primary practice location
52 Carly CT
East Stroudsburg, PA 18301-8004
Mailing address
52 Carly CT
East Stroudsburg, PA 18301-8004
Phone (201) 522-0577
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 121427-1 | NY | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322611200000",
"number": "1366564262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "52 CARLY CT",
"city": "EAST STROUDSBURG",
"state": "PA",
"postal_code": "183018004",
"telephone_number": "201-522-0577",
"fax_number": "646-349-1395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "52 CARLY CT",
"city": "EAST STROUDSBURG",
"state": "PA",
"postal_code": "183018004",
"telephone_number": "201-522-0577",
"fax_number": "646-349-1395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORONADO",
"first_name": "RAUL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-04",
"last_updated": "2011-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "121427-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Stroudsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.