Healthcare Provider Details

I. General information

NPI: 1992769715
Provider Name (Legal Business Name): ADAM D. CORRADO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 FRANKLIN ST STE 1
WATERBURY CT
06706-1281
US

IV. Provider business mailing address

55 BROOKMOOR RD
AVON CT
06001-2303
US

V. Phone/Fax

Practice location:
  • Phone: 203-709-3031
  • Fax:
Mailing address:
  • Phone: 860-404-1898
  • Fax: 208-730-1341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number241584
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number042.0013085
License Number StateVT
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number241979
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number31217
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number65627-20
License Number StateWI
# 6
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number045844
License Number StateCT
# 7
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA82470
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: