1326300419 NPI number — PAULINE SUSAN CORTI MS SPECIAL EDUCATIO

Table of content: PAULINE SUSAN CORTI MS SPECIAL EDUCATIO (NPI 1326300419)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326300419 NPI number — PAULINE SUSAN CORTI MS SPECIAL EDUCATIO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CORTI
Provider First Name:
PAULINE
Provider Middle Name:
SUSAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS SPECIAL EDUCATIO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CARBONE
Provider Other First Name:
PAULINE
Provider Other Middle Name:
SUSAN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS SPECIAL EDUCATION
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1326300419
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/13/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
464 ROUTE 17A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLORIDA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10921-1014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-533-1020
Provider Business Mailing Address Fax Number:
845-651-2258

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
464 ROUTE 17A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLORIDA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10921-1014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-533-1020
Provider Business Practice Location Address Fax Number:
845-651-2258
Provider Enumeration Date:
06/13/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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