MEDICARE: ANNEMARIE CORBETT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	40QA01290500	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1316362494	OTHER	NJ	CHAMPION REHABILITATION LLC GROUP NPI

General Provider Information

NPI Number	:	1841267325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNEMARIE CORBETT

Provider Business Mailing Address
First Line	:	2500 ENGLISH CREEK AVE
Second Line	:	LIFECENTER, 2ND FLOOR
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-5549
Country	:	US
Telephone Number	:	609-677-7268
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 ENGLISH CREEK AVE
Second Line	:	LIFECENTER, 2ND FLOOR
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-5549
Country	:	US
Telephone Number	:	609-677-7268
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2006
Last Update Date	:	07/27/2014

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Directions to “ ANNEMARIE CORBETT ” Practice Location

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