MEDICARE: MS. JOAN THERESA CORREALE SHOP OWNER

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
1	1744P3200X	Prosthetics Case Management

General Provider Information

NPI Number	:	1669421327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOAN THERESA CORREALE SHOP OWNER

Provider Business Mailing Address
First Line	:	326 NEW DORP LN
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-3035
Country	:	US
Telephone Number	:	718-984-1134
Fax Number	:

Provider Business Practice Location Address
First Line	:	326 NEW DORP LN
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-3035
Country	:	US
Telephone Number	:	718-984-1134
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	07/16/2008

Similar Medicare Providers

1053596957 — JULECOR DBA FRENCH SECRETS LINGERIE
Practice Location Address:

326 NEW DORP LN
STATEN ISLAND, NY
10306-3035

Practice Phone: 718-979-3522
Practice Fax:

1699171728 — VERNIECE GREEN-FULFORD
Practice Location Address:

360 NEW DORP LN STE C
STATEN ISLAND, NY
10306-3035

Practice Phone: 929-333-6905
Practice Fax: 929-566-8627

1033914874 — CDJR CONSULTING LLC
Practice Location Address:

360 NEW DORP LN
STATEN ISLAND, NY
10306-3035

Practice Phone: 718-814-7797
Practice Fax:

1386445195 — CARING PHARMACY INCORPORATED
Practice Location Address:

342A NEW DORP LN
STATEN ISLAND, NY
10306-3035

Practice Phone: 585-888-3098
Practice Fax: 585-888-3128

1689810566 — DR. DIANNA MARIE D AMORE MSPT, DPT
Practice Location Address:

15 GREENCROFT AVE
STATEN ISLAND, NY
10308-3035

Practice Phone: 718-986-5037
Practice Fax:

1861914236 — GINA SMARSCH
Practice Location Address:

96 STURGES STREET
STATEN ISLAND, NY
10314-3035

Practice Phone: 718-876-7617
Practice Fax:

Directions to “ MS. JOAN THERESA CORREALE SHOP OWNER” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.