Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 9310 | NY |
Y | 103TC0700X | Clinical Psychologist | 9310 | NY |
NPI | 1013125129 |
---|---|
Provider Name | Dr. Louis Joseph Corrado |
First Address | Huntington, NY 11743-6917 |
Second Address | Centerport, NY 11721-1311 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 08/07/2007 |