MEDICARE: DOMINICK CORBETT MSW

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1972911451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOMINICK CORBETT MSW

Provider Business Mailing Address
First Line	:	369 WEST ST
Second Line	:
City	:	PITTSFIELD
State	:	MA
Zip	:	01201-5731
Country	:	US
Telephone Number	:	413-442-1503
Fax Number	:

Provider Business Practice Location Address
First Line	:	369 WEST ST
Second Line	:
City	:	PITTSFIELD
State	:	MA
Zip	:	01201-5731
Country	:	US
Telephone Number	:	413-442-1503
Fax Number	:

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

Provider Enumeration Date	:	07/28/2014
Last Update Date	:	07/28/2014

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Directions to “ DOMINICK CORBETT MSW” Practice Location

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