Healthcare Provider Details

I. General information

NPI: 1801166301
Provider Name (Legal Business Name): THOMAS J. CORSO MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/31/2011
Last Update Date: 12/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 W BROAD ST
BETHLEHEM PA
18018-5518
US

IV. Provider business mailing address

214 W BROAD ST
BETHLEHEM PA
18018-5518
US

V. Phone/Fax

Practice location:
  • Phone: 610-965-8984
  • Fax:
Mailing address:
  • Phone: 610-965-8984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: