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General NPI Number Information
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NPI Number | 1730016239
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Entity Type | Individual
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Provider Name | CARISSA CORCORAN
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Gender | Female
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Dates
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Enumeration Date | 05/07/2026
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Last Update Date | 05/07/2026
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Provider Practice Location Address
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Address Line | 325 WOOD RD STE 108
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City | BRAINTREE
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State | MA
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Zip | 02184-2000
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Country | US
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Telephone | 781-535-6053
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Fax | 781-535-6056
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Provider Business Mailing Address
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Address Line | 73 NEWTON RD UNIT 101
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City | PLAISTOW
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State | NH
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Zip | 03865-2440
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Country | US
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Telephone | 978-388-7272
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTL89410
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License Number State | MA
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