Gary Stephen Coren, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD011770E Issued in PA

Practice address

10800 Knights Rd
Attn: Radiology
Philadelphia, PA 19114-4200

Phone

(215) 612-2610

Fax

(215) 612-5077

NPI assigned

Jan 19, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1699755298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 782743",
            "address_2": "ATTN: CREDENTIALING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191782743",
            "telephone_number": "602-910-6887",
            "fax_number": "215-612-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "address_2": "ATTN: RADIOLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200",
            "telephone_number": "215-612-2610",
            "fax_number": "215-612-5077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COREN",
        "first_name": "GARY",
        "middle_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD011770E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Core Performance Physicians, LLC
• Core Wellness Centers LLC
• Corecare Behavioral Health
• Corecare Behavioral Health Management, Inc.
• Freda Coren, MD
• Megumi Kondo Corley, DMD
• Eli Joseph Cornblath, MD, PHD
• Corneal Associates, PC
• Leslie J. Cornely, RN
• Corner Dentistry LLP

• Diagnostic Radiology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Diagnostic Radiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.