Provider Demographics
NPI:1053416297
Name:CORONADO, AMBER LIM (AUD)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:LIM
Last Name:CORONADO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:MARIE
Other - Last Name:LIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1025 KLEM RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-8618
Mailing Address - Country:US
Mailing Address - Phone:585-217-4798
Mailing Address - Fax:585-758-1297
Practice Address - Street 1:1025 KLEM RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-8618
Practice Address - Country:US
Practice Address - Phone:585-872-1320
Practice Address - Fax:585-872-2067
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTAUD5035231H00000X
NY002165231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist