Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | MT215088 | PA |
NPI | 1245256098 |
---|---|
Provider Name | Dr. Scott Corelli |
First Address | Allentown, PA 18105-1556 |
Second Address | Allentown, PA 18103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 13/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02670400 | (05) | NY |
I30331 | (02) |