MEDICARE: DOMINICK CORBETT MSW

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1972911451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOMINICK CORBETT MSW

Provider Business Mailing Address
First Line	:	60 ACADEMY RD
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12208-3103
Country	:	US
Telephone Number	:	518-426-2600
Fax Number	:

Provider Business Practice Location Address
First Line	:	375 BAY RD
Second Line	:
City	:	QUEENSBURY
State	:	NY
Zip	:	12804-3012
Country	:	US
Telephone Number	:	518-741-0043
Fax Number	:

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

Provider Enumeration Date	:	07/28/2014
Last Update Date	:	06/03/2026

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