Provider Demographics
NPI:1699567545
Name:POLANCO CORPORAN, YOXANDRY (MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:YOXANDRY
Middle Name:
Last Name:POLANCO CORPORAN
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 HARMON COVE TOWER
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-1729
Mailing Address - Country:US
Mailing Address - Phone:201-699-2973
Mailing Address - Fax:
Practice Address - Street 1:224 HARMON COVE TOWER
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-1729
Practice Address - Country:US
Practice Address - Phone:201-699-2973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPENDING363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily