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General NPI Number Information
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NPI Number | 1437499191
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Entity Type | Individual
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Provider Name | MISS TONI LEIGH CORSELLO
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Gender | Female
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Dates
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Enumeration Date | 02/18/2013
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Last Update Date | 02/19/2013
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Provider Practice Location Address
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Address Line | 153 BEACH 124TH ST
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City | BELLE HARBOR
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State | NY
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Zip | 11694-1839
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Country | US
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Telephone | 917-567-6353
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Fax |
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Provider Business Mailing Address
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Address Line | 153 BEACH 124TH ST
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City | BELLE HARBOR
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State | NY
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Zip | 11694-1338
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Country | US
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Telephone | 917-567-6353
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 702681131
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 702681131
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License Number State | NY
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