Healthcare Provider Details

I. General information

NPI: 1336937630
Provider Name (Legal Business Name): EMMANUEL JEAN-PHILIPPE CORECHI-P, HAITIAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 WICKSHIRE CIR
LITITZ PA
17543-7669
US

IV. Provider business mailing address

620 WICKSHIRE CIR
LITITZ PA
17543-7669
US

V. Phone/Fax

Practice location:
  • Phone: 717-406-9148
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number017021
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: