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NPI Code Detail

MEDICARE: CHRISTINE CORACI

MEDICARE: CHRISTINE CORACI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker099534NY

General Provider Information

NPI Number : 1477115038
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE CORACI
Provider Business Mailing Address
First Line : 1413 STONY BROOK RD
Second Line :
City : STONY BROOK
State : NY
Zip : 11790-2214
Country : US
Telephone Number : 631-444-0101
Fax Number :
Provider Business Practice Location Address
First Line : 1413 STONY BROOK RD
Second Line :
City : STONY BROOK
State : NY
Zip : 11790-2214
Country : US
Telephone Number : 631-444-0101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2019
Last Update Date : 07/03/2019

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Directions to “ CHRISTINE CORACI ” Practice Location

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