MEDICARE: DR. CORAZON CIPRIASO MD

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	225400000X	Rehabilitation Practitioner	25MA07358200	NJ
2	208100000X	Physical Medicine & Rehabilitation Physician	25MA07358200	NJ

General Provider Information

NPI Number	:	1851371801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CORAZON CIPRIASO MD

Provider Business Mailing Address
First Line	:	PO BOX 790
Second Line	:
City	:	OLD BRIDGE
State	:	NJ
Zip	:	08857-0790
Country	:	US
Telephone Number	:	732-492-8241
Fax Number	:	888-685-8722

Provider Business Practice Location Address
First Line	:	1 TANGLEWOOD PL E
Second Line	:
City	:	MONROE TWP
State	:	NJ
Zip	:	08831-3268
Country	:	US
Telephone Number	:	908-601-5296
Fax Number	:	866-506-2790

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

Provider Enumeration Date	:	01/17/2006
Last Update Date	:	07/22/2022

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