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General NPI Number Information
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NPI Number | 1679625545
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Entity Type | Organization
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Legal Business Name | CORSO REHABILITATION PT PC
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 11/02/2011
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Provider Practice Location Address
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Address Line | 2375B NEW YORK AVE
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-4258
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Country | US
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Telephone | 631-673-2933
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Fax | 631-673-3086
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Provider Business Mailing Address
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Address Line | 2375B NEW YORK AVE
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-4258
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Country | US
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Telephone | 631-673-2933
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Fax | 631-673-3086
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Authorized Official
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Title or Position | CO-OWNER
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Name | MR. ANTHONY F CORSO
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Credential | PT
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Telephone | 631-673-2933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 010018
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License Number State | NY
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